制定核心指标来识别有延迟心力衰竭诊断风险的人
K Barber1,2, L Bernhardt1,2, G P McCann2
1Leicestershire Partnership NHS Trust, Leicester, UK.
BMC primary care
|October 16, 2025
概括
延迟心力衰竭 (HF) 诊断与患者的知识,获得护理和临床因素有关. 在初级保健中识别关键指标可以改善早期检测和患者的结果.
科学领域:
- 心脏病学 心脏病学
- 初级医疗保健医学 一级医疗保健医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心力衰竭 (HF) 诊断往往会延迟到住院,导致死亡率和疾病严重程度更高.
- 多方面的患者,临床和服务层面因素导致HF诊断延迟.
- 在初级保健中早期发现未诊断的HF对于改善患者的治疗结果至关重要.
研究的目的:
- 为了在患者,临床和服务层面的因素上达成共识,与延迟HF诊断相关.
- 在初级保健中确定早期检测未诊断的HF的指标.
- 在初级保健环境中为及时HF诊断提供信息的策略.
主要方法:
- 一个经过三轮修改的e-Delphi过程,涉及初级和专科护理的患者和临床医生.
- 参与者评价社会人口统计学,临床和服务水平因素对于延迟HF诊断的重要性.
- 共识定义为三分之二的同意;指标被>50%的临床医生排在前5位.
主要成果:
- 在延迟HF诊断的15个因素和5个指标上达成共识.
- 关键因素包括患者的HF知识,接触专家,症状混,多病症和肥胖.
- 服务级别因素包括有限的N-终端亲B型天然尿素 (NT-proBNP) 测试和初级保健中的回声心电图.
- 未诊断的HF的主要指标包括高NT-proBNP没有转诊和循环利尿剂的使用.
结论:
- 识别出关键因素和指标可以促进早期的HF诊断在初级保健.
- 这些指标可以集成到基于电子健康记录的警报中,以提供决策支持.
- 实施这些发现可以改善及时检测和治疗心力衰竭.
更多相关视频
07:49Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach
Published on: July 21, 2023
1.9K
04:05Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
Published on: June 30, 2023
2.7K
相关概念视频
01:30Heart Failure IV: Classification and Diagnostic Evaluation
317
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
317
01:26Heart Failure III: Clinical Manifestations
473
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
473
01:27Heart Failure I: Introduction
678
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
678
01:29Heart Failure II: Pathophysiology
707
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
707
01:30Heart Failure VII: Nursing Interventions
413
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
413
01:30Acute Coronary Syndrome III: Diagnostic Studies
209
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...
209