Epidemiological study examining changes in practice with the introduction of a coronary catheterization complication prediction application.

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K17332
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: Keio University
• Principal Investigator: Sawano Mitsuaki 慶應義塾大学, 医学部(信濃町), 共同研究員 (00796104)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 冠動脈疾患 / カテーテル治療 / 合併症予測 / 疫学研究

Outline of Final Research Achievements

This epidemiological study examines whether the incidence of the three major perioperative complications (major bleeding, acute kidney injury, and use of dialysis) that are predictable and preventable can be reduced when predicted risk of complications for individual patients are recognized by the treating physician prior to percutaneous coronary intervention. In the year 2019, risk prediction and preprocedural risk presentation was pursued in Kawasaki City Municipal Hospital. At Keio University Hospital, a risk prediction application was developed. In the year 2020 and 2021, we registered the data of electronic medical record data into a survey form on a dedicated website, together with clinical research coordinators, to examine the actual status of PCI practice at both sites. After the year 2020, coordinators were restricted from entering the data due to the COVID-19 outbreak. The impact of the risk prediction is yet to be investigated.

Free Research Field

循環器分野

Academic Significance and Societal Importance of the Research Achievements

本邦における同様の研究の先例はないことから本研究をさらに前向きの介入研究とし展開できればさらに因果検証が可能となる。同様の試みがこれまでに米国カンザス大学と数施設で実施されたことがあり、重大出血リスクが高い患者に対しての適切な出血回避行動がとられるように変化したことをSpertusらが報告（BMJ 2015;350:h1302）している。しかし、人種や文化、医療制度、承認されている薬剤・デバイスなどが異なる日本で同様の手法から良好な結果が得られるかはわかっておらず、急性腎障害および透析導入のリスクについても提示することで、幅広い合併症の抑制効果が得られるかを検証する意義が高い。