https://scholars.lib.ntu.edu.tw/handle/123456789/495881
標題: | Impact of hospital volume on long-term neurological outcome in patients undergoing carotid artery stenting | 作者: | CHI-SHENG HUNG CHIH-FAN YEH MAO-SHIN LIN YING-HSIEN CHEN CHING-CHANG HUANG HUNG-YUAN LI HSIEN-LI KAO |
公開日期: | 2017 | 出版社: | John Wiley and Sons Inc. | 卷: | 89 | 期: | 7 | 起(迄)頁: | 1242-1249 | 來源出版物: | Catheterization and Cardiovascular Interventions | 摘要: | Background: The impact of hospital volume on long-term outcome after carotid artery stenting (CAS) remains unknown. Objectives: We designed a nationwide cohort study to elucidate the impact of hospital volume on the incidence of stroke after CAS. Methods: The Taiwan National Health Insurance Research database was used to identify all patients admitted for CAS from 2008 to 2012. We defined high-volume hospitals as those performing more than 20 CAS per year. The primary outcome was new ischemic stroke after discharging from the index CAS. Propensity score-matching was performed to create two matched groups for comparison. Results: A total of 3,248 patients underwent 3,576 CAS procedures were enrolled. There were 56 hospitals performing CAS during the study period. Among these 3,248 patients, 2,226 (68.5%) were performed in high-volume hospitals. A propensity score-matching created two groups with 1,000 patients in each group. During a median of 2.06 years follow-up, 35 (3.5%) and 52 (5.2%) patients in high-volume hospitals and low-volume hospitals developed new ischemic stroke 30 days after discharging from the index CAS, respectively (for low-volume hospitals, HR 1.50, 95%CI 1.06–2.12, P = 0.023). The use of embolic protection device did not result in different periprocedural or postdischarge strokes. The periprocedural (within 30 days after CAS) ischemic stroke or all-cause mortality rates during follow-up period were similar between two groups. Conclusions: CAS performed in high-volume hospitals was associated with less new ischemic stroke after discharging from the index CAS, compared to those in low-volume hospitals. ? 2017 Wiley Periodicals, Inc. ? 2017 Wiley Periodicals, Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85015227940&doi=10.1002%2fccd.26989&partnerID=40&md5=8da9af374adc6b682c10236035a21ee4 https://scholars.lib.ntu.edu.tw/handle/123456789/495881 |
ISSN: | 1522-1946 | DOI: | 10.1002/ccd.26989 | SDG/關鍵字: | aged; Article; brain ischemia; carotid artery stenting; cerebrovascular accident; clinical effectiveness; cohort analysis; controlled study; female; high volume hospital; human; low volume hospital; major clinical study; male; mortality rate; neurologic disease; outcome assessment; Taiwan; angioplasty; brain ischemia; carotid artery disease; cerebrovascular accident; chi square distribution; clinical trial; comparative study; devices; diagnostic imaging; epidemiology; factual database; incidence; middle aged; mortality; multicenter study; propensity score; proportional hazards model; risk factor; stent; time factor; treatment outcome; very elderly; Aged; Aged, 80 and over; Angioplasty; Brain Ischemia; Carotid Artery Diseases; Chi-Square Distribution; Databases, Factual; Female; Hospitals, High-Volume; Hospitals, Low-Volume; Humans; Incidence; Male; Middle Aged; Propensity Score; Proportional Hazards Models; Risk Factors; Stents; Stroke; Taiwan; Time Factors; Treatment Outcome |
顯示於: | 醫學系 |
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