LVAD植入后女性和男性的社会心理风险和复发住院:INTERMACS登记的多状态分析

IF 2.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Lisa-Marie Maukel, Sandra Schmeller, Gerdi Weidner, Jan Beyersmann, Heike Spaderna
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引用次数: 0

摘要

背景:与男性相比,女性在左心室辅助装置(LVAD)植入后的不良事件发生率和首次再住院率更高。本研究调查了性别和植入前心理社会风险在反复住院中的作用。方法:分析20123例INTERMACS患者(21.3%为女性)的数据。估计累积转换率(例如,从家到住院),并根据协变量调整Andersen-Gill模型,检查性别、植入前社会心理风险和再住院累积转换危险之间的关系。对国家职业概率、平均住院人数和累计平均住院时间进行了计算,并按性别和社会心理风险进行了分层。结果:植入前心理社会风险在男性中比女性更普遍(21.4%比17.5%,p < 0.001)。独立于协变量,女性性别和社会心理风险的相互作用增加了再住院风险[HRadj 1.11, 95% CI (1.01-1.22), p = 0.036]。植入后一年,有心理社会风险的女性和无心理社会风险的女性分别住院2.2次和1.8次,而男性分别住院1.8次和1.7次。有心理社会风险的女性住院时间为20天,无心理社会风险的女性住院时间为16天,男性住院时间为15天,男性住院时间为14天(均p < 0.001)。结论:植入前的社会心理风险是lvad后复发住院的独立因素,尤其是对女性。这些因素的早期识别和管理可以减少再住院和改善临床结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Psychosocial Risk and Recurrent Hospitalizations in Women and Men Following LVAD Implantation: A Multi-State Analysis of the INTERMACS Registry.

Background: Women experience higher rates of adverse events and first rehospitalization after left ventricular assist device (LVAD) implantation compared with men. This study investigated the role of sex and preimplant psychosocial risk in recurrent hospitalizations.

Methods: Data from 20,123 INTERMACS patients (21.3% women) were analyzed. Cumulative transition rates (e.g., home to hospitalization) were estimated and Andersen-Gill models, adjusted for covariates, examined the association between sex, preimplant psychosocial risk, and cumulative transition hazards for rehospitalization. State occupation probabilities, the mean number of hospitalizations, and the cumulative average length of hospital stay were calculated and stratified by sex and psychosocial risk.

Results: Psychosocial risk preimplant was more prevalent in men than in women (21.4% vs. 17.5%, p < 0.001). The interaction of female sex and psychosocial risk increased rehospitalization hazards, independently of covariates [HRadj 1.11, 95% CI (1.01-1.22), p = 0.036]. One-year postimplant, women with vs. without psychosocial risk had 2.2 vs. 1.8 hospitalizations, while men experienced 1.8 vs. 1.7 hospitalizations, respectively. Women with vs. without psychosocial risk spent 20 vs.16 days hospitalized, and men 15 vs. 14 days (all p < 0.001).

Conclusions: Preimplant psychosocial risk independently contributed to recurrent hospitalizations post-LVAD, particularly affecting women. The early identification and management of these factors may reduce rehospitalizations and improve clinical outcomes.

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来源期刊
Journal of Cardiovascular Development and Disease
Journal of Cardiovascular Development and Disease CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
12.50%
发文量
381
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