Preliminary effectiveness of the whole-life cycle management model for valvular heart disease at West China Hospital: A retrospective cohort study
- VernacularTitle:华西医院心脏瓣膜病全生命周期管理模式应用初步成效的回顾性队列研究
- Author:
Zechao RAN
1
;
Yuqiang WANG
1
;
Siyu HE
1
;
Shitong ZHONG
1
;
Tingqian CAO
2
;
Xiang LIU
3
;
Zeruxin LUO
4
;
Lulu LIU
5
;
Jun SHI
5
;
Yingqiang GUO
1
Author Information
1. 1. Cardiovascular Surgery Research Laboratory, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China 2. Department of Cardiovascular Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
2. Integrated Care Management Center, Outpatient Department, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
3. Information Technology Center, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
4. Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
5. Cardiovascular Surgery Research Laboratory, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
- Publication Type:Journal Article
- Keywords:
Valvular heart disease;
whole-life cycle management model;
disease management specialist;
health services
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(07):968-976
- CountryChina
- Language:Chinese
-
Abstract:
Objective To propose a whole-life cycle management model for valvular heart disease (VHD), systematically elucidate its underlying logic and implementation pathways, and concurrently review and analyze its preliminary application outcomes. Methods Since 2020, West China Hospital of Sichuan University has established a management system encompassing "assessment-decision-intervention-follow-up", including: (1) a risk-stratified, tiered management pathway; (2) six core functions ("promotion, screening, prevention, diagnosis, treatment, and rehabilitation") coordinated by disease-specific managers; (3) an intelligent decision support information platform; and (4) a collaborative network of multidisciplinary teams and regional academic alliances. To evaluate the effectiveness of this management model, we retrospectively included three cohorts: (1) the population screened by echocardiography from 2020 to 2024, analyzing the detection rate of aortic valve disease and risk stratification; (2) patients enrolled in the whole-life cycle management from April 2021 to December 2024, assessing follow-up outcomes, hospital satisfaction, and changes in quality of life; (3) patients who underwent transcatheter aortic valve replacement (TAVR) from January 2022 to January 2024, evaluating the one-year all-cause mortality rate, perioperative complications, and improvements in New York Heart Association (NYHA) classification. Results Between 2020 and 2024, a total of 583 874 individuals underwent echocardiographic screening. A total of 48 089 patients with aortic valve disease were identified, including 3 401 (7.1%) high-risk patients, 18 657 (38.8%) moderate-risk patients, and 26 031 (54.1%) low-risk patients. Among them, 2 417 patients were enrolled in whole-life cycle management. Patient satisfaction scores showed a yearly increase, rising from 73.89 points before 2020 to 93.74 points in 2024. The 1-year mortality rate in the TAVR cohort decreased to 5.3%, significantly lower than the 8.2% observed under early standard management between 2014 and 2019 (P<0.01). Conclusion Through process optimization and resource integration, the VHD whole-life cycle management model has demonstrated significant effectiveness in standardizing diagnostic and follow-up procedures, enhancing patient satisfaction and quality of life, and reducing mortality. These outcomes highlight its practical value for broader implementation in China.
