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首页> 外文期刊>The American Journal of Cardiology >Impact of On-Site Surgical Backup on Periprocedural Outcomes of Primary Percutaneous Interventions in Patients Presenting With ST-Segment Elevation Myocardial Infarction (From the ORPKI Polish National Registry)
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Impact of On-Site Surgical Backup on Periprocedural Outcomes of Primary Percutaneous Interventions in Patients Presenting With ST-Segment Elevation Myocardial Infarction (From the ORPKI Polish National Registry)

机译：现场外科备份对患有ST段抬高心肌梗死（来自ORPKI Polish National Registry）的患者原发性经皮干预患者的人群疗效的影响

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摘要

Conflicting data exist regarding the associations between on-site surgical backup and outcomes after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Thus, we sought to assess the impact of such a backup on periprocedural outcomes of primary PCI using data from the Polish National Registry of PCI. From 2014 to 2016 data on 66,707 patients presenting with STEMI undergoing primary PCI from 154 centers were collected. Patients were divided into 2 groups based on the presence of on-site surgical backup. Of 66,707 patients, 15,040 (22.6%) patients were treated in 28 centers with on-site surgical backup. On-site surgical backup was associated with a higher center PCI annual volume (662.4 ± 301.8 vs 1098.7 ± 483.5; p <0.001), but a lower operator PCI annual volume (226.7 ± 126.0 vs 207.8 ± 96.6; p <0.001). The periprocedural mortality (1.60% vs 1.09%; p <0.001) was lower in patients from centers with on-site cardiac surgery and both on-site surgical backup (odds ratio [95% confidence interval], 0.618 [0.517; 0.738]; p <0.001) and the mean number of PCIs by operator per year (odds ratio per 10 [95% confidence interval], 0.990 [0.984; 0.996]; p?=?0.001] were independent predictors of periprocedural death. In conclusion, results of our study suggest that periprocedural mortality in patients undergoing primary PCI for STEMI is lower in centers than without on-site cardiac surgical backup. Whether this effect on mortality is attributable to such backup itself and/or whether surgical backup is a marker of?overall better medical care and adherence to professional guidelines, this needs clarification in further studies.
机译：存在关于在初步经皮冠状动脉干预（PCI）后现场手术备份和结果的关联的相互冲突数据进行ST段抬高心肌梗死（STEMI）。因此，我们试图利用来自PCI的波兰国家登记处的数据来评估备份对主PCI的Periprocedural结果的影响。从2014年到2016年到2016年，收集了由154个中心接受初级PCI的66,707名患者的数据。基于现场外科备用的存在，患者分为2组。在66,707名患者中，15,040名（22.6％）患者在28个中心，在现场手术备份中均配。现场外科备份与更高的中心PCI年度体积相关（662.4±301.8 Vs 1098.7±483.5; P <0.001），但操作员PCI年龄较低（226.7±126.0 Vs 207.8±96.6; P <0.001）。从中心心脏手术的中心患者患者（1.60％vs 1.09％; p <0.001）较低，均在现场心脏手术和内部手术备用（差距偏置率[95％置信区间]，0.618 [0.517; 0.738]; P <0.001）和每年运营商的平均PCIS数量（每10次（95％置信区间），0.990 [0.984; 0.996]; p？= 0.001]是霸权死亡的独立预测因子。总之，结果我们的研究表明，在没有现场心脏外科备份的情况下，接受初级PCI的患者的患者患者的霸王性死亡率较低。这种对死亡率的这种影响是否可归因于这种备用本身和/或手术备份是什么更好的医疗和遵守专业指南，这需要进一步研究。

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