在老年患者中选择性穿皮冠状动脉干预后,当天出院的患病率和结果
Sunil V Rao1, Lisa A Kaltenbach, William S Weintraub
1Duke Clinical Research Institute, 508 Fulton St, Durham, North Carolina, USA. sunil.rao@duke.edu
JAMA
|October 6, 2011
概括
选择性穿皮冠状动脉干预 (PCI) 后的当日出血在老年患者中不常见,但不会增加在30天内死亡或再住院的风险. 这种方法对于精选的低风险个体是安全的.
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
背景情况:
- 选择性穿皮冠状动脉干预 (PCI) 通常涉及老年患者的夜间住院观察.
- 对这个人口群体来说,当天出院的安全性仍然不清楚.
研究的目的:
- 确定在美国接受选择性PCI的老年患者当日出院的患病率和结果.
- 评估同日出院和死亡或再住院等不良事件之间的关联.
主要方法:
- 一项多中心队列研究分析了65岁以上的107,018名接受PCI的患者的数据.
- 数据来源于CathPCI注册表 (2004-2008) 并与医疗保险索赔相关联.
- 患者被分为同一天出院或过夜的组.
主要成果:
- 同一天排放很少 (1.25%),设施层面的变化很大.
- 两组之间没有观察到2天或30天死亡或再住院率的显著差异.
- 经过调整后的分析显示,当天放药与30天的不良结果没有显著关联.
结论:
- 对于接受选择性PCI的老年低风险患者,不经常使用当日出院.
- 这种做法似乎是安全的,与夜间观察相比,没有增加死亡或再入院的风险.
相关概念视频
Acute Coronary Syndrome IV: Interprofessional Care
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Coronary Artery Disease V: Interprofessional Care
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Cardiac Catheterization IV: Nursing Management
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
