在接受标准化心血管风险评估的孕妇和产后妇女中进行心血管检测的结果
Afshan B Hameed1, Maryam Tarsa2, Ashten Waks3
1Division of Maternal-Fetal Medicine, Department Obstetrics & Gynecology, School of Medicine, University of California, Irvine, CA (Hameed, Waks, Balogun, and Thiel de Bocanegra); Division of Cardiology, Department of Medicine, School of Medicine, University of California, Irvine, CA (Hameed).
一个标准化的心血管疾病 (CVD) 风险评估发现更多的孕妇有异常的测试结果,而不是仅靠临床医生的判断. 该工具有助于检测未知的或正在发展的心血管疾病,以改善孕产妇健康结果.
科学领域:
- 心脏病学 心脏病学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 公共卫生 公共卫生
背景情况:
- 心血管疾病 (CVD) 是美国孕产妇死亡的主要原因.
- 标准化的心血管疾病风险评估可以在怀孕期间识别有风险的患者.
研究的目的:
- 为了比较标准化心血管疾病风险评估与仅仅临床医生的判断在确定孕妇和产后患者心血管疾病异常发现方面的有效性.
主要方法:
- 在三个医院网络中,对31,232名孕妇/产后患者的回顾性图表审查.
- 在标准化评估和临床医生判断小组之间比较异常的复合脑性尿素 (BNP),心电图 (EKG) 和/或心声图测试结果.
- 使用两个比例Z测试和几率比率进行统计分析.
主要成果:
- 标准化评估发现更多的异常测试 (6.9%) 超过临床医生的判断 (4.2%;p<.0001).
- 风险阳性患者的异常测试几率 (4.31倍) 与风险阴性患者相比显著更高 (p<.0001).
- 通过标准化工具评估的患者的异常测试几率是仅通过临床医生的判断评估的患者的1.69倍 (P<.0001).
结论:
- 标准化的心血管疾病风险评估提高了在孕妇/产后患者中检测到以前未知的或正在发展的心血管疾病.
- 这种算法可以作为临床医生判断的宝贵补充,以改善围产期结果.
- 早期识别和管理怀孕期间心血管疾病风险对于降低产妇死亡率至关重要.
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