门诊心力衰竭过程护理措施与死亡率之间的关联
Gregg C Fonarow1, Nancy M Albert, Anne B Curtis
1Department of Medicine, Ahmanson–UCLA Cardiomyopathy Center, Los Angeles, CA 90095-1679, USA. gfonarow@mednet.ucla.edu
Circulation
|April 6, 2011
概括
高质量的心力衰竭 (HF) 护理措施与更好的生存率有关. 坚持HF过程措施,包括药物和教育,改善了患者的结果,并可以指导质量评估.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 临床结果 临床结果
背景情况:
- 心力衰竭 (HF) 门诊患者的护理质量通常依赖于基于过程的绩效指标.
- 这些HF护理过程措施与临床结果之间的关联尚未被彻底评估.
- 这项研究探讨了当前和新兴的门诊HF措施与患者存活率之间的联系.
研究的目的:
- 评估既定和新型门诊心力衰竭 (HF) 过程措施与患者存活率之间的关联.
- 为了确定是否遵守HF护理指南会影响临床结果.
- 评估HF过程措施在评估和改善患者护理方面的有用性.
主要方法:
- 从美国167家门诊心脏病诊所对15177名患有减排率 (≤35%) 的患者进行了24个月的前性随访.
- 评估了7个HF过程措施 (4个当前,3个新兴) 和2个基线的总结措施.
- 多变量分析以评估工艺措施与24个月死亡率之间的关系.
主要成果:
- 七种特定的HF过程措施 (ACE抑制剂/ARB,β阻塞剂,AF抗凝剂,CRT,ICD,HF教育) 独立地与24个月生存率的改善有关.
- 使用阿尔多激素抗剂与改善的生存率没有显著关联.
- 综合护理总结措施显示,与生存有显著的关联;10%的改善与13%的死亡率下降相关 (aOR,0.87).
结论:
- 目前和新兴的门诊心力衰竭 (HF) 过程测量表明与患者存活率的积极关联.
- 这些HF措施是评估和提高HF护理质量的宝贵工具.
- 这些发现支持在临床实践和质量改进计划中使用这些过程措施.
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