基于团队的标准化护理对随着时间的推移对心脏性休克结果的影响
Behnam N Tehrani1, Carolyn M Rosner1,2, Adetokunbo Fadahunsi2
1Inova Schar Heart and Vascular, Inova Fairfax Medical Campus, Falls Church, Virginia, USA.
ESC heart failure
|November 5, 2025
概括
对心脏性休克 (CS) 的标准化护理保持了持续的住院死亡率,尽管患者的个人资料和治疗方法在不断变化. 需要进一步的研究,以获得最佳的离院后护理模式.
科学领域:
- 心脏病学 心脏病学
- 临界护理医学 临界护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 关于标准化护理方案对心脏性休克 (CS) 结果的长期影响的数据有限.
- 2017年实施了多学科管理和以团队为基础的协议,以标准化CS护理.
研究的目的:
- 研究标准化,多学科的CS管理对患者随着时间的推移的影响.
- 为了比较CS患者的特征,管理策略和协议实施前后的结果.
主要方法:
- 从2017年至2022年,在单一中心的CS注册表中对1453名连续患者进行了回顾性分析.
- 患者被分为两个队列:2017-2019年和2020-2022年.
- 调整的住院死亡率是主要终点,使用多变量回归分析.
主要成果:
- 从2017-2019年到2020-2022年,接受治疗的CS患者数量显著增加 (523人与930人相比).
- 晚期的患者更频繁地呈现出先进的CS (较高的SCAI B/C分类) 和与心力衰竭相关的CS.
- 尽管管理方式发生了变化 (减少PVAD,增加ECMO/移植),但调整后的住院死亡率仍保持一致 (aOR 0.81;P=0.25).
结论:
- 对心脏性休克的标准化护理与随着时间的推移稳定的住院死亡率有关.
- 自标准化协议实施以来,CS的患者介绍和管理策略已经发展.
- 进一步研究最佳的退院后护理模式对于改善长期CS患者的治疗结果至关重要.
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