دورية أكاديمية
Hospital Procedural Volume and Clinical Outcomes Following Septal Reduction Therapy in Obstructive Hypertrophic Cardiomyopathy.
| العنوان: | Hospital Procedural Volume and Clinical Outcomes Following Septal Reduction Therapy in Obstructive Hypertrophic Cardiomyopathy. |
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| المؤلفون: | Altibi AM; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University Portland OR USA., Ghanem F; Internal Medicine Department East Tennessee State University Johnson City TN USA., Zhao Y; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University Portland OR USA., Elman M; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University Portland OR USA.; OHSU-PSU School of Public Health Oregon Health and Science University Portland OR USA., Cigarroa J; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University Portland OR USA., Nazer B; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University Portland OR USA.; Now with Division of Cardiovascular Medicine University of Washington Medical Center Seattle WA USA., Song HK; Division of Cardiothoracic Surgery Knight Cardiovascular Institute, Oregon Health and Science University Portland OR USA., Masri A; Hypertrophic Cardiomyopathy Center, Division of Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University Portland OR USA. |
| المصدر: | Journal of the American Heart Association [J Am Heart Assoc] 2023 May 16; Vol. 12 (10), pp. e028693. Date of Electronic Publication: 2023 May 15. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Oxford : Wiley-Blackwell |
| مواضيع طبية MeSH: | Ethanol* , Cardiomyopathy, Hypertrophic*/surgery, Humans ; United States/epidemiology ; Hospital Mortality ; Treatment Outcome ; Heart Septum/diagnostic imaging ; Heart Septum/surgery ; Hospitals, High-Volume |
| مستخلص: | Background Prior national data showed a substantial in-hospital mortality in septal myectomy (SM) with an inverse volume-outcomes relationship. This study sought to assess the contemporary outcomes of septal reduction therapy and volume-outcome relationship in obstructive hypertrophic cardiomyopathy. Methods and Results All septal reduction therapy admissions between 2010 to 2019 in the United States were analyzed using the National Readmission Databases. Hospitals were stratified into tertiles of low-, medium-, and high-volume based on annualized procedural volume of alcohol septal ablation and SM. Of 19 007 patients with obstructive hypertrophic cardiomyopathy who underwent septal reduction therapy, 12 065 (63%) had SM. Two-thirds of hospitals performed ≤5 SM or alcohol septal ablation annually. In all SM encounters, 482 patients (4.0%) died in-hospital post-SM. In-hospital mortality was <1% in 1505 (88.4%) hospitals, 1% to 10% in 30 (1.8%) hospitals, and ≥10% in 167 (9.8%) hospitals. There were 63 (3.7%) hospitals (averaging 2.2 SM cases/year) with 100% in-hospital mortality. Post-SM (in low-, medium-, and high-volume centers, respectively), in-hospital mortality (5.7% versus 3.9% versus 2.4%, P =0.003; adjusted odds ratio [aOR], 2.86 [95% CI, 1.70-4.80], P =0.001), adverse in-hospital events (21.30% versus 18.0% versus 12.6%, P =0.001; aOR, 1.88 [95% CI, 1.45-2.43], P =0.001), and 30-day readmission (17.1% versus 12.9% versus 9.7%, P =0.001; adjusted hazard ratio, 1.53 [95% CI, 1.27-1.96], P =0.001) were significantly higher in low- versus high-volume hospitals. For alcohol septal ablation, the incidence of in-hospital death and all other outcomes did not differ by hospital volume. Conclusions In-hospital SM mortality was 4% with an inverse volume-mortality relationship. Mortality post-alcohol septal ablation was similar across all volume tertiles. Morbidity associated with SM was substantial across all volume tertiles. |
| التعليقات: | Comment in: J Am Heart Assoc. 2023 May 16;12(10):e030194. (PMID: 37183877) |
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| فهرسة مساهمة: | Keywords: alcohol septal ablation; hypertrophic cardiomyopathy; septal myectomy; septal reduction therapy |
| المشرفين على المادة: | 3K9958V90M (Ethanol) |
| تواريخ الأحداث: | Date Created: 20230515 Date Completed: 20230518 Latest Revision: 20230601 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC10227305 |
| DOI: | 10.1161/JAHA.122.028693 |
| PMID: | 37183831 |
| قاعدة البيانات: | MEDLINE |
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