The Development And Application Of Automatic Monitoring System For Adverse Events After Percutaneous Cardiovascular Intervention

1.Objective: To development an adverse event monitoring system after PCI and evaluate the effectiveness of the monitoring system, then extracted the clinical data to analysis the risk factors of early stent thrombosis after PCI and contrast induced nephropathy after PCI in patients with acute coronary syndrome.2.Methods: (1) The monitoring system is connected with the hospital information system in real time, and the clinical data of all patients are included in the system to construct the medical information database of PCI patients.(2) 2041 consecutive cases of PCI from May 2015 to August 2015 were selected in this study, compare artificial verification through one by one and monitoring system monitoring results, calculate the authenticity and reliability of the identification of adverse event monitoring system.(3) Extracts clinical data through the monitoring system of patients from January 1, 2010 to December 31, 2015 in General Hospital of PL A, EST after PCI as case group, and patients without EST after PCI as control group, analyzed their clinical data, so as to find the risk factors of EST after PCI.(4) Extracts clinical data through the monitoring system about ACS patients with CIN after PCI, who were in PLA General Hospital from January 2014 to January 2015, compared with those of ACS patients without CIN after PCI, analyzed their clinical data, to find out the risk factors of CIN in patients with ACS after PCI.3.Results: (1) The monitoring system can realize real-time monitoring of the PCI postoperative adverse events, it has function of statistical analysis, structure analysis,ranking analysis,traceability analysis and data extraction,achieve the data management of PCI postoperative adverse events.(2) In the selected patients, the sensitivity of the monitoring system for the identification of adverse events after PCI was as high as 94.5%, the specificity was as high as 98.6%, the accuracy was as high as 98.2%, and the recognition accuracy of high-risk adverse events could be as high as 100%.(3) Emergency PCI, total stent length, low LVEF, combined with OSA are independent risk factors for EST after PCI.(4) Older than 70 years old, with CRI, the dosage of contrast agent is more than 200ml,systolic blood pressure at admission was lower than 100mmhg, LVEF<50%, white blood cell count>10×1012mmol/L, Troponin T>0.5ng/ml, BNP>300ng/ml are independent risk factors for CIN in patients with ACS after PCI.4.Conclusion: (1) The PCI postoperative adverse event monitoring system has high sensitivity, specificity and accuracy to identify the complications, the data is true and reliable, can save manpower, real-time feedback, and is worthy of clinical promotion.(2)This study found that emergency PCI, total stent length, low LVEF, combined with OSA are independent risk factors for the formation of EST after PCI.(3) Older than 70 years old, with CRI, the dosage of contrast agent is more than 200ml,systolic blood pressure at admission was lower than 100mmhg, LVEF<50%, white blood cell count>10×1012mmol/L, Troponin T>0.5ng/ml, BNP>300ng/ml are independent risk factors for CIN in patients with ACS after PCI.