当前位置： SCI文献检索 > JOURNAL OF VASCULAR SURGERY期刊下所有文献 > Diffusion of new technology for the treatment of renovascular hypertension in the United States: surgical revascularization versus catheter-based therapy, 1988-2001.

Diffusion of new technology for the treatment of renovascular hypertension in the United States: surgical revascularization versus catheter-based therapy, 1988-2001.

Abstract：

BACKGROUND:Trends in the management of renovascular hypertension were evaluated by using a representative national database to determine whether a shift in treatment technology and outcomes has occurred. METHODS:Clinical information regarding the treatment of renovascular hypertension in 5433 patients from 1988 to 2001 was derived from the Nationwide Inpatient Sample (NIS) database. Patients were classified into 3 groups: combined aortic and renal revascularization, isolated renal revascularization, and catheter-based procedures (angioplasty with or without stenting). Population-based trends were determined by using sampling weights for each year to estimate the total number of each intervention in the United States. Outcomes were compared using multivariate logistic regression analysis for risk-adjustment. RESULTS:A 73% decrease in combined aortic and renal revascularizations ( P = .033) and a 56% decrease in isolated renal revascularizations ( P < .001) occurred during the study period. Catheter-based procedures have increased 173% from 0.4 to 1.1 procedures per 100,000 adults during this same time period ( P < .001). Predictors favoring catheter-based treatment were admission acuity, increasing age, nonwhite race, and high socioeconomic status. Predictors of mortality for all 3 treatment groups included increasing age, emergent admission, and nonwhite race. CONCLUSIONS:A significant change in the management of patients with renovascular hypertension has occurred, with a shift towards less invasive catheter-based interventions. A better understanding of the diffusion of this technology in the treatment of individuals with renovascular hypertension will influence the training and distribution of future vascular specialists responsible for these patients.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Knipp BS,Dimick JB,Eliason JL,Cowan JA,Henke PK,Proctor MS,Stanley JC,Upchurch GR

doi

10.1016/j.jvs.2004.07.029

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

717-23

issue

eissn

0741-5214

issn

1097-6809

pii

S0741521404009486

journal_volume

pub_type

杂志文章

在线工具

Diffusion of new technology for the treatment of renovascular hypertension in the United States: surgical revascularization versus catheter-based therapy, 1988-2001.