持续贫困与心脏手术患者的结果的关联
Lovette Azap1, Selamawit Woldesenbet2, Henrique Lima2
1Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Center, Columbus, Ohio; Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
The Journal of surgical research
|August 12, 2023
概括
持续的县级贫困与心脏手术患者的死亡风险增加有关. 这突显了手术结果的社会经济差异,强调了有针对性的干预措施的必要性.
科学领域:
- 心血管外科心血管外科
- 医疗保健服务研究 医疗服务研究
- 健康的社会经济决定因素
背景情况:
- 社会经济因素显著影响健康结果.
- 了解持续贫困对心脏手术的影响对于公平护理至关重要.
研究的目的:
- 调查县级贫困持续时间和大心脏手术后的结果之间的关联.
- 为了确定居住在持续贫困地区的患者是否面临更高的风险.
主要方法:
- 分析医疗保险数据 (2016-2020年) 冠状动脉旁路移植,大动脉置换和心心门手术.
- 基于县贫困状况的患者分层 (从未高,间歇性,持久) 使用美国社区调查和美国农业部数据 (1980-2015).
- 利用混合效应和考克斯回归模型,调整患者级别的共变量以评估死亡风险.
主要成果:
- 持续贫困 (PP) 县的患者比从来没有高贫困 (NHP) 县的患者更有可能年轻,非西班牙裔黑人,来自南方州.
- PP患者接受了更多的非选择性手术.
- 与NHP相比,持续的贫困与30天和90天死亡率的几率显著增加,以及长期死亡风险更高.
结论:
- 县级持续贫困是心脏手术患者不良结果的重要风险因素.
- 这些发现强调了社会经济环境对手术结果和患者存活率的影响.
- 解决社会经济差距对于改善心脏手术护理平等至关重要.
相关概念视频
Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
Cardiomyopathy V: Interprofessional Care
16
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
16
Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
Cardiomyopathy VI: Nursing Management
13
Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
13
Cardiomyopathy IV: Restrictive Cardiomyopathy
12
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
12
Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K


