利用真实世界数据对意大利二尖瓣反流的临床和经济负担进行回顾性分析。

IF 2.7 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Paolo Sciattella, Belén Martí-Sánchez, Matteo Vernia, Stefano Giardina, Federico De Marco
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引用次数: 0

摘要

简介:二尖瓣反流(MR)是欧洲第二大常见瓣膜疾病,发病率不断上升,造成重大的医疗负担并影响生活质量。尽管它具有临床重要性,但现实世界中关于核磁共振负担的数据有限。目的:本研究旨在估计MR患病率,描述患者概况,评估医疗资源利用和相关成本,通过退化性(DMR)和功能性(FMR)病因分层,使用来自意大利的真实数据。方法:回顾性研究意大利2018年出院的MR患者,根据合并症和临床标准将队列分为退行性MR (DMR)和功能性MR (FMR)。患者随访12个月,以评估所接受的干预措施,包括手术(SMVr)和经导管二尖瓣修复(TMVr),以及住院时间、住院死亡率和相关费用。结果:2018年,5816例符合入选标准的患者因MR住院(DMR占83.6%,FMR占16.4%)。在DMR患者中,44.2%的患者接受了孤立性瓣膜修复(89.7%的SMVr, 10.3%的TMVr),而29.1%的FMR患者接受了修复(59.6%的SMVr, 40.4%的TMVr)。TMVr患者年龄较大(DMR: 41.6%, FMR: 42.9%,年龄≥75岁),合并症较多。与治疗组相比,未经治疗的患者1年住院死亡率更高(DMR: 4.7%, FMR: 8.5%), 1年后再干预率最高(DMR: 19.9%, FMR: 13.3%)。DMR患者的再干预率(SMVr: 0.4%, TMVr: 0%)低于FMR患者(SMVr: 0.6%, TMVr: 0.9%)。干预措施之间的成本差异可以忽略不计,主要反映了每种干预类型所适用的不同DRG关税。结论:未经治疗的MR与较差的临床结果和较高的长期资源使用相关。这些发现支持早期干预策略,并强调需要改善获得护理的机会,特别是对高危人群。进一步的研究是必要的,以探讨门诊护理和解决治疗差距。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Retrospective Analysis of the Clinical and Economic Burden of Mitral Regurgitation in Italy Using Real-World Data.

Introduction: Mitral regurgitation (MR) is the second most common valve disease in Europe with an increasing prevalence, causing a significant healthcare burden and impacting quality of life. Despite its clinical importance, real-world data on MR burden are limited.

Objectives: This study aimed to estimate MR prevalence, describe patient profiles, and assess healthcare resource utilization and related costs, stratified by degenerative (DMR) and functional (FMR) aetiologies, using real-world data from Italy.

Methods: A retrospective study using Italy's Hospital Discharge Records was conducted including patients discharged in 2018 with a diagnosis of MR. The cohort was stratified into degenerative (DMR) and functional MR (FMR) based on comorbidities and clinical criteria. Patients were followed for 12 months to assess interventions received, including surgical (SMVr) and transcatheter mitral valve repair (TMVr), as well as length of stay, in-hospital mortality, and associated costs.

Results: In 2018, 5816 patients who met the eligibility criteria were hospitalised with MR (83.6% DMR, 16.4% FMR). Among DMR patients, 44.2% underwent isolated valve repair (89.7% SMVr, 10.3% TMVr), while 29.1% of FMR patients received repair (59.6% SMVr, 40.4% TMVr). TMVr patients were older (DMR: 41.6%, FMR: 42.9% aged ≥75 years) and had more comorbidities. Untreated patients had higher 1-year in-hospital mortality (DMR: 4.7%, FMR: 8.5%) compared to treated groups and the highest reintervention rate at 1 year (DMR: 19.9%, FMR: 13.3%). Re-intervention rates were lower in DMR (SMVr: 0.4%, TMVr: 0%) versus FMR (SMVr: 0.6%, TMVr: 0.9%). The cost differences between interventions were negligible, primarily reflecting the different DRG tariffs applied for each intervention type.

Conclusions: Untreated MR is associated with worse clinical outcomes and higher long-term resource use. These findings support early intervention strategies and highlight the need to improve access to care, especially for high-risk populations. Further studies are warranted to explore outpatient care and address treatment disparities.

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来源期刊
CiteScore
5.90
自引率
3.10%
发文量
108
审稿时长
6-12 weeks
期刊介绍: Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.
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