A streamlined pathway for transcatheter aortic valve implantation: the BENCHMARK study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Frank Derk, Durand Eric, Lauck Sandra, Muir Douglas F, Spence Mark, Vasa-Nicotera Mariuca, Wood David, Saia Francesco, Urbano-Carrillo Cristóbal A, Bouchayer Damien, Iliescu Vlad Anton, Saint Etienne Christophe, Leclercq Florence, Auffret Vincent, Asmarats Lluis, Di Mario Carlo, Veugeois Aurelie, Maly Jiri, Schober Andreas, Nombela-Franco Luis, Werner Nikos, Gómez-Hospital Joan Antoni, Mascherbauer Julia, Musumeci Giuseppe, Meneveau Nicolas, Meurice Thibaud, Mahfoud Felix, De Marco Federico, Seidler Tim, Leuschner Florian, Joly Patrick, Collet Jean-Philippe, Vogt Ferdinand, Di Lorenzo Emilio, Kuhn Elmar, Disdier Vicente Peral, Hachaturyan Violetta, Lüske Claudia M, Rakova Radka, Wesselink Wilbert, Kurucova Jana, Bramlage Peter, McCalmont Gemma, BENCHMARK Investigator Group
Аннотация
METHODS: This was a study of patients with severe symptomatic aortic stenosis (AS) undergoing TAVI with balloon-expandable valves before and after implementation of BENCHMARK best practices. Principal objectives were to reduce hospital length of stay (LoS) and duration of intensive care stay. Secondary objective was to document patient safety.
RESULTS: Between January 2020 and March 2023, 897 patients were documented prior to and 1491 patients after the implementation of BENCHMARK practices. Patient characteristics were consistent with a known older TAVI population and only minor differences. Mean LoS was reduced from 7.7 ± 7.0 to 5.8 ± 5.6 days (median 6 vs. 4 days; P < .001). Duration of intensive care was reduced from 1.8 to 1.3 days (median 1.1 vs. 0.9 days; P < .001). Adoption of peri-procedure best practices led to increased use of local anaesthesia (96.1% vs. 84.3%; P < .001) and decreased procedure (median 47 vs. 60 min; P < .001) and intervention times (85 vs. 95 min; P < .001). Thirty-day patient safety did not appear to be compromised with no differences in all-cause mortality (0.6% in both groups combined), stroke/transient ischaemic attack (1.4%), life-threatening bleeding (1.3%), stage 2/3 acute kidney injury (0.7%), and valve-related readmission (1.2%).
CONCLUSIONS: Broad implementation of BENCHMARK practices contributes to improving efficiency of TAVI pathway reducing LoS and costs without compromising patient safety.