Academic Journal
Initial Thoracic Endovascular Aortic Repair vs Medical Therapy for Acute Uncomplicated Type B Aortic Dissection
| العنوان: | Initial Thoracic Endovascular Aortic Repair vs Medical Therapy for Acute Uncomplicated Type B Aortic Dissection |
|---|---|
| المؤلفون: | Weissler, E Hope, Osazuwa-Peters, Oyomoare L, Greiner, Melissa A, Hardy, N Chantelle, Kougias, Panagiotis, O'Brien, Sean M, Mark, Daniel B, Jones, W Schuyler, Secemsky, Eric A, Vekstein, Andrew M, Shalhub, Sherene, Mussa, Firas F, Patel, Manesh R, Vemulapalli, Sreekanth |
| المصدر: | Journal Articles |
| بيانات النشر: | DigitalCommons@TMC |
| سنة النشر: | 2023 |
| المجموعة: | Houston Academy of Medicine-Texas Medical Center (HAM-TMC): DigitalCommons@The Texas Medical Center |
| مصطلحات موضوعية: | Adult, Humans, Aged, Female, United States, Male, Endovascular Aneurysm Repair, Aortic Aneurysm, Thoracic, Blood Vessel Prosthesis Implantation, Treatment Outcome, Cohort Studies, Prospective Studies, Quality of Life, Endovascular Procedures, Medicare, Aortic Dissection, Hypertension, Cardiology, Cardiovascular Diseases, Diseases, Medical Specialties, Medicine and Health Sciences |
| الوصف: | IMPORTANCE: Thoracic endovascular aortic repair (TEVAR) has increasingly been used for uncomplicated type B aortic dissection (uTBAD) despite limited supporting data. OBJECTIVE: To assess whether initial TEVAR following uTBAD is associated with reduced mortality or morbidity compared with medical therapy alone. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included Centers for Medicare & Medicaid Services inpatient claims data for adults aged 65 years or older with index admissions for acute uTBAD from January 1, 2011, to December 31, 2018, with follow-up available through December 31, 2019. EXPOSURES: Initial TEVAR was defined as TEVAR within 30 days of admission for acute uTBAD. MAIN OUTCOMES AND MEASURES: Outcomes included all-cause mortality, cardiovascular hospitalizations, aorta-related and repeated aorta-related hospitalizations, and aortic interventions associated with initial TEVAR vs medical therapy. Propensity score inverse probability weighting was used. RESULTS: Of 7105 patients with eligible index admissions for acute uTBAD, 1140 (16.0%) underwent initial TEVAR (623 [54.6%] female; median age, 74 years [IQR, 68-80 years]) and 5965 (84.0%) did not undergo TEVAR (3344 [56.1%] female; median age, 76 years [IQR, 69-83 years]). Receipt of TEVAR was associated with region (vs South; Midwest: adjusted odds ratio [aOR], 0.66 [95% CI, 0.53-0.81]; P < .001; Northeast: aOR, 0.63 [95% CI, 0.50-0.79]; P < .001), Medicaid dual eligibility (aOR, 0.76; 95% CI, 0.63-0.91; P = .003), hypertension (aOR, 1.26; 95% CI, 1.03-1.54; P = .03), peripheral vascular disease (aOR, 1.24; 95% CI, 1.02-1.49; P = .03), and year of admission (2012, 2013, 2014, and 2015 were associated with greater odds of TEVAR compared with 2011). After inverse probability weighting, mortality was similar for the 2 strategies up to 5 years (hazard ratio [HR], 0.95; 95% CI, 0.85-1.06), as were aorta-related hospitalizations (HR, 1.12; 95% CI, 0.99-1.27), aortic interventions (HR, 1.01; 95% CI, 0.84-1.20), and ... |
| نوع الوثيقة: | text |
| وصف الملف: | application/pdf |
| اللغة: | unknown |
| Relation: | https://digitalcommons.library.tmc.edu/uthmed_docs/969; https://digitalcommons.library.tmc.edu/context/uthmed_docs/article/1956/viewcontent/Initial_Thoracic_Endovascular_Aortic_Repair_vs_Medical_Therapy_for_Acute_Uncomplicated_Type_B_Aortic_Dissection___PMC.pdf |
| الاتاحة: | https://digitalcommons.library.tmc.edu/uthmed_docs/969 https://digitalcommons.library.tmc.edu/context/uthmed_docs/article/1956/viewcontent/Initial_Thoracic_Endovascular_Aortic_Repair_vs_Medical_Therapy_for_Acute_Uncomplicated_Type_B_Aortic_Dissection___PMC.pdf |
| رقم الانضمام: | edsbas.6E935829 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |