Heart & Lung最新文献

{"title":"Effectiveness and safety of emergency transcatheter aortic valve replacement in patients with severe aortic stenosis complicated by cardiogenic shock: A systematic review and meta-analysis","authors":"Yifan Deng ,&nbsp;Shiyang Wei ,&nbsp;Li Zhu ,&nbsp;Luhang Tao","doi":"10.1016/j.hrtlng.2024.09.011","DOIUrl":"10.1016/j.hrtlng.2024.09.011","url":null,"abstract":"<div><h3>Background</h3><div>The application of transcatheter aortic valve replacement (TAVR) has been developed on different populations in many clinical studies. However, research dedicated to the application of emergency TAVR in patients with aortic stenosis (AS) experiencing cardiogenic shock is limited.</div></div><div><h3>Objective</h3><div>To investigate the safety and effectiveness of emergency TAVR in AS patients with circulatory collapse.</div></div><div><h3>Methods</h3><div>Studies on the application of emergency TAVR in AS patients with cardiogenic shock were screened from PubMed, Web of Science, and Embase databases. Two researchers independently screened the literature-extracted data and conducted a meta-analysis was conducted using STATA 16.0 software.</div></div><div><h3>Results</h3><div>17 studies comprising 36,886 patients undergoing emergency TAVR and 8,530 patients undergoing emergency SAVR or BAV. Emergency TAVR showed no difference in valve implantation success rate compared to elective TAVR. At 30-day endpoints comparison, emergency TAVR exhibited significantly higher all-cause mortality and readmission rates than elective TAVR (RR=2.73 95 %CI 2.04–3.65, <em>P</em> &lt; 0.01; RR=1.2 95 %CI 0.9–1.6, <em>P</em> &lt; 0.01), but reduced mortality risk compared to emergency SAVR/BAV (RD=-0.15 95 %CI -0.25 to -0.04, <em>P</em> = 0.005). At one year post-operation, people with emergency TAVR continued to have higher all-cause mortality than elective TAVR (RR=1.55 95 %CI 1.37–1.74, <em>P</em> &lt; 0.01) but similar with emergency SAVR/BAV (RD=-0.04 95 %CI -0.33 to 0.25, <em>P</em> = 0.796). Rates of severe bleeding and new-onset renal dialysis were higher after emergency TAVR, compared to elective TAVR, while the incidences of permanent pacemaker implantation, severe paravalvular leakage and stroke were similar.</div></div><div><h3>Conclusion</h3><div>Despite emergency TAVR having higher readmission and mortality rates compared to elective TAVR, it is a relatively safe and effective treatment in cases of cardiogenic shock compared to emergency BAV/SAVR.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 62-70"},"PeriodicalIF":2.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding attendance patterns and determinants in cardiac, pulmonary, and ICU Rehabilitation/Recovery programs: A systematic review and meta-analysis","authors":"Leanne M. Boehm PhD, RN, ACNS-BC ,&nbsp;Kelly Potter PhD, RN ,&nbsp;Joanne McPeake PhD, MSc, BN (Hons), RGN ,&nbsp;Martin Shaw PhD, MSci ,&nbsp;Han Su PhD, RN ,&nbsp;Abigail C. Jones MEd, RN ,&nbsp;Valerie Renard MSN, AGACNP-BC, CCRN ,&nbsp;Tammy L. Eaton PhD, MSc, RN, FNP-BC ,&nbsp;Carl Boethel MD ,&nbsp;Javed Butler MD, MPH, MBA ,&nbsp;Rachel Lane Walden MLIS ,&nbsp;Valerie Danesh PhD, RN","doi":"10.1016/j.hrtlng.2024.09.010","DOIUrl":"10.1016/j.hrtlng.2024.09.010","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac, pulmonary, and intensive care unit (ICU) rehabilitation/recovery programs are health promotion interventions designed to improve physical recovery, psychological well-being, and quality of life after acute illness while reducing the risk of adverse events.</div></div><div><h3>Objective</h3><div>Identify the difference in attendance rates for patients invited to a cardiac rehabilitation, pulmonary rehabilitation, or ICU recovery program and factors influencing attendance.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis by searching PubMed, EMBASE, CINAHL, Web of Science, and manual reference lists from inception to June 3, 2024. We included studies reporting patient attendance rates in eligible programs following acute illness hospitalization. Two team members independently screened articles and extracted data, with a third member reviewing and achieving consensus when necessary. Our main outcomes focused on the proportion of attendance in eligible programs among patients referred.</div></div><div><h3>Results</h3><div>Of 3,446 studies screened, 179 studies (<em>N</em> = 4,779,012 patients) were included across cardiac rehabilitation (<em>n</em> = 153 studies), pulmonary rehabilitation (<em>n</em> = 11 studies), and ICU recovery (<em>n</em> = 15 studies) programs. Pooled attendance rates were 53 % (95 % CI: 48-57 %) for cardiac rehabilitation, 56 % (95 % CI: 42-70 %) for pulmonary rehabilitation, and 61 % (95 % CI: 51-70 %) for ICU recovery programs. Significant attendance heterogeneity was present (cardiac I²=100 %, <em>p</em> &lt; 0.001; pulmonary I²=100 %, <em>p</em> &lt; 0.001; ICU I²=94 %, <em>p</em> &lt; 0.01). Barriers to attendance included transportation, distance, work conflicts, and patient factors (e.g., comorbidities, older age). Facilitators included male gender, younger age, higher education, income, provider recommendations, and flexible scheduling. Individual factors represented the primary domain affecting attendance.</div></div><div><h3>Conclusions</h3><div>The results indicate comparable attendance rates and factors shaping attendance across acute illness rehabilitation/recovery programs, with ICU recovery programs being the most well-attended on average.</div></div><div><h3>Registration</h3><div>PROSPERO CRD42022357261</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 51-61"},"PeriodicalIF":2.4,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S014795632400181X/pdfft?md5=18f572d2d5ee58f86ebf90f64359cfa6&pid=1-s2.0-S014795632400181X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of exercise-based prehabilitation in patients undergoing coronary artery bypass grafting surgery: A systematic review of randomized controlled trials","authors":"Hidaye Yamikan,&nbsp;Gamze Nur Ahiskali,&nbsp;Aynur Demirel,&nbsp;Ebru Calik Kütükcü","doi":"10.1016/j.hrtlng.2024.09.007","DOIUrl":"10.1016/j.hrtlng.2024.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative exercise-based rehabilitation improves the physical performance and health-related outcomes of patients undergoing coronary artery bypass grafting (CABG). However, the effectiveness of exercise-based prehabilitation in patients undergoing CABG remains unknown.</div></div><div><h3>Objective</h3><div>The purpose of this systematic review was to investigate the effects of exercise-based prehabilitation on functional exercise capacity, postoperative complications, anxiety, depression, self-efficacy, quality of life, length of hospital and intensive care unit stay, frailty, and endothelial function in patients undergoing CABG surgery.</div></div><div><h3>Methods</h3><div>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study protocol is recorded in the PROSPERO database (registration number CRD42023488530). PubMed, the Physiotherapy Evidence Database (PEDro), Google Scholar, Web of Science, Scopus, and the Cochrane Library were searched from inception to December 2023. The titles and abstracts of the studies were screened using Rayyan Ai software. After full-text screening, randomized controlled trials that met the inclusion criteria were included.</div></div><div><h3>Results</h3><div>Five randomized controlled trials involving 616 participants were included. The systematic review suggests strong evidence that exercise-based prehabilitation improved functional capacity and moderate evidence that it reduced postoperative complications and length of hospital stay. Although there was conflicting evidence regarding the effects of exercise-based prehabilitation on quality of life, there was limited evidence of its effects on physical activity, anxiety, depression, self-efficacy, frailty, and endothelial function.</div></div><div><h3>Conclusions</h3><div>Exercise-based prehabilitation can be recommended for improvements in functional capacity, postoperative complications, and length of hospital stay in patients undergoing CABG.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 41-50"},"PeriodicalIF":2.4,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “The association between food environment and cardiovascular disease outcomes: A systematic review” [Heart & Lung, volume 68 (2024), Pages 359-366/YMHL2427]","authors":"Yu Jia Liu ,&nbsp;Xiao Qin Wang ,&nbsp;Guiqin Zhang ,&nbsp;Qiansheng Zhao ,&nbsp;Yu Xin Cheng ,&nbsp;Shuo Liu ,&nbsp;Bing Xiang Yang ,&nbsp;Dan Luo ,&nbsp;Qian Liu ,&nbsp;Huijing Zou","doi":"10.1016/j.hrtlng.2024.09.009","DOIUrl":"10.1016/j.hrtlng.2024.09.009","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Page 40"},"PeriodicalIF":2.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001808/pdfft?md5=c7128c7a3c130103d0f341066cc3af3b&pid=1-s2.0-S0147956324001808-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifiable risk factors and motivation for lifestyle change of CVD patients starting cardiac rehabilitation: The BENEFIT study","authors":"Linda D. Breeman ,&nbsp;Andrés Pérez-Alonso ,&nbsp;David Kühling-Romero ,&nbsp;Roderik A. Kraaijenhagen ,&nbsp;Isra Al-Dhahir ,&nbsp;Renée V.H. IJzerman ,&nbsp;Roxy van Eersel ,&nbsp;Katherine Wolstencroft ,&nbsp;Tobias N. Bonten ,&nbsp;Douwe E. Atsma ,&nbsp;Niels H. Chavannes ,&nbsp;Lisette van Gemert-Pijnen ,&nbsp;Hareld M.C. Kemps ,&nbsp;Wilma Scholte op Reimer ,&nbsp;Andrea W.M. Evers ,&nbsp;Veronica R. Janssen ,&nbsp;BENEFIT consortium","doi":"10.1016/j.hrtlng.2024.09.008","DOIUrl":"10.1016/j.hrtlng.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><p>To improve lifestyle guidance within cardiac rehabilitation (CR), a comprehensive understanding of the motivation and lifestyle-supporting needs of patients with cardiovascular disease (CVD) is required.</p></div><div><h3>Objectives</h3><p>This study's purpose is to evaluate patients’ lifestyle and their motivation, self-efficacy and social support for change when starting CR.</p></div><div><h3>Methods</h3><p>1782 CVD patients (69 % male, mean age 62 years) from 7 Dutch outpatient CR centers participated between 2020 and 2022. Modifiable risk factors were assessed with a survey and interviews by healthcare professionals during CR intake.</p></div><div><h3>Results</h3><p>Most patients exhibited an elevated risk in 3–4 domains. Elevated risks were most prominent in domains of (1) waist circumference and BMI (2) physical exercise (3) healthy foods intake and (4) sleep duration. Most patients chose to focus on increasing physical exercise, but about 20 % also wanted to focus on a healthy diet and/or decrease stress levels. Generally, motivation, self-efficacy and social support to reach new lifestyle goals were high. However, patients with an unfavorable risk profile had lower motivation and self-efficacy to work on lifestyle changes, while patients with lower social support had a higher chance to quit the program prematurely.</p></div><div><h3>Conclusions</h3><p>Our results underscore the need to begin CR with a comprehensive lifestyle assessment and highlight the importance of offering lifestyle interventions tailored to patients’ specific modifiable risk factors and lifestyle-supporting needs, targeting multiple lifestyle domains. Expanding the current scope of CR programs to address diverse patient needs and strengthening support may enhance motivation and adherence and lead to significant long-term benefits for cardiovascular health.</p></div><div><h3>Clinical trial registration number</h3><p>Netherlands Trial Register; registration number NL8443</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 31-39"},"PeriodicalIF":2.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001651/pdfft?md5=41c918c7f17d3c92e14e108bd66a4dbb&pid=1-s2.0-S0147956324001651-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of aerobic exercise-based pulmonary rehabilitation on quality of life in pediatric asthma: A systematic review and meta-analysis","authors":"Qunying Ma ,&nbsp;Min Lu ,&nbsp;Qiying Yang ,&nbsp;Feng Gong ,&nbsp;Li Zhou ,&nbsp;Dandan Xu","doi":"10.1016/j.hrtlng.2024.09.005","DOIUrl":"10.1016/j.hrtlng.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><p>Pediatric asthma poses a significant global health burden, impacting the well-being and daily lives of affected children. Aerobic exercise-based pulmonary rehabilitation emerges as a promising intervention to address the multifaceted challenges faced by pediatric asthma patients.</p></div><div><h3>Objectives</h3><p>The purpose of this systematic review and meta-analysis was to comprehensively evaluate the effects of aerobic exercise-based pulmonary rehabilitation on pulmonary function and quality of life in pediatric asthma patients.</p></div><div><h3>Methods</h3><p>Randomized controlled trials (RCTs) involving pediatric participants (5–18 years) were included. Aerobic exercise program-based pulmonary rehabilitation interventions were assessed for their impact on actual and percentage predicted values of lung volumes and flow rates such as forced vital capacity (FVC), maximum mid-expiratory flow (FEF25–75), peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), FEV1/FVC, and on quality of life (QoL) measures. A systematic search of databases, hand-searching, and consultation with experts identified relevant studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines guided study selection, data extraction, and quality assessment.</p></div><div><h3>Results</h3><p>The systematic review included 20 studies with diverse exercise interventions and outcomes. The meta-analysis using fixed-effects model showed that there was a significant improvement in FVC (% predicted) [SMD= 0.30, 95 %CI: 0.13, 0.48] and FEF25–75 (% predicted) [SMD= 0.31, 95 %CI: 0.03, 0.58] in the experimental group compared with the control group. Furthermore, using a random-effects model involving 12 studies, significant increases in the QoL [SMD= 0.70, 95 %CI: 0.14, 1.26] were found in the exercise group. Due to inter-study heterogeneity, additional analyses were conducted. Publication bias analysis indicated robustness, with no significant asymmetry in funnel plots.</p></div><div><h3>Conclusion</h3><p>Aerobic exercise-based pulmonary rehabilitation significantly enhances pulmonary function and quality of life in pediatric asthma patients. The findings, supported by improvements in FVC and FEF25–75, demonstrate the efficacy of these interventions. Quality of life measures also showed notable improvements. Despite inter-study heterogeneity, the results are robust, suggesting that aerobic exercise should be considered a valuable non-pharmacological strategy in managing pediatric asthma.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 11-30"},"PeriodicalIF":2.4,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001614/pdfft?md5=be205720d66d0a6ec660e3fc0a3375f9&pid=1-s2.0-S0147956324001614-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing and content of serious illness conversations for patients with advanced heart failure in a specialty-aligned palliative care service","authors":"Hanna-Riikka Lehto MD, PhD ,&nbsp;Nelia Jain MD, MA ,&nbsp;Katharine A. Manning MD, MBE ,&nbsp;Joshua R. Lakin MD ,&nbsp;Christina Sheu BA ,&nbsp;Amanda J. Reich PhD, MPH ,&nbsp;Akshay S. Desai MD, MPH ,&nbsp;Kate R. Sciacca NP ,&nbsp;Charlotta J. Lindvall MD, PhD ,&nbsp;James A. Tulsky MD ,&nbsp;Rachelle E. Bernacki MD, MSc","doi":"10.1016/j.hrtlng.2024.09.004","DOIUrl":"10.1016/j.hrtlng.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><p>Patients with advanced heart failure (AHF) desire communication around values and goals prior to treatment decisions.</p></div><div><h3>Objectives</h3><p>To evaluate the timing and content of the first serious illness communication (SI conversation) for patients with AHF after referral to a specialist palliative care (PC) team (HeartPal).</p></div><div><h3>Methods</h3><p>In this retrospective cohort study, we used electronic health records to identify patients referred to HeartPal and their first SI conversations at a tertiary care hospital between October 2018 and September 2021. We used natural language processing and predetermined codes to quantify prevalence of prior goals of care conversations by the cardiology team within six months preceding the HeartPal consultation and the prevalence of hopes, fears, and seven conversation content codes. Consecutive SI conversations and patient outcomes were followed until March 2022.</p></div><div><h3>Results</h3><p>Of 468 patients (mean age: 64 years, 72 % male, 66 % referred for goals of care conversation), 25.2 % had prior documented goals of care conversations preceding the HeartPal consultation. During the study period, 206 (44.0 %) patients died (median time from initial SI conversation to death: 65 days, IQR 206) and 43.2 % engaged in multiple SI conversations before death. SI conversation analysis (<em>n</em> = 324) revealed that patients hoped to “be at home” (74.1 %, <em>n</em> = 240), “be independent” (65.7 %, <em>n</em> = 213) and “live as long as possible” (53.4 %, <em>n</em> = 173). Conversation content included goals of care (83.0 %), strengths (83.0 %), decision-making (79.3 %), spirituality (71.0 %), coping (52.2 %), and prognostic communication (43.5 %).</p></div><div><h3>Conclusion</h3><p>Specialist PC service provides documentation of goals and values and offers longitudinal follow-up for patients with AHF.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 1-10"},"PeriodicalIF":2.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142167378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating frailty management into cardiac intensive care unit nursing practice: A qualitative study","authors":"Fang Chen ,&nbsp;Zhenzhen Liu ,&nbsp;Ling Zong ,&nbsp;Qian Wang ,&nbsp;Liwen Zhang","doi":"10.1016/j.hrtlng.2024.09.006","DOIUrl":"10.1016/j.hrtlng.2024.09.006","url":null,"abstract":"<div><h3>Background</h3><p>Frailty is prevalent among older patients in intensive care units (ICUs) and poses significant challenges to recovery. Despite its importance, there is limited research on effective nurse-led frailty management strategies in this context.</p></div><div><h3>Objective</h3><p>The purpose of this qualitative study was to explore nurses' perceptions of frailty management in cardiac ICUs through the lens of the Wuli-Shili-Renli (WSR) system approach.</p></div><div><h3>Methods</h3><p>Sixteen nurses from two tertiary hospitals in Shandong province, China, participated in semi-structured interviews. Participants were selected based on their involvement in frailty training, educational background, and cardiac ICU work experience. Thematic analysis was conducted to identify key themes and sub-themes.</p></div><div><h3>Results</h3><p>Analysis in three categories revealed the need for foundational support, including the need for appropriate screening tools, updated evidence-based practices, and institutional support. Closed-loop management involved frailty screening, personalized program implementation, information management, and follow-up assessment. Personnel training and coordination emphasized enhancing nurses' professionalism, multidisciplinary teamwork, and cooperation from patients and their caregivers.</p></div><div><h3>Conclusion</h3><p>The insights gained can inform evidence-based practices and improve the quality of care provided to frail patients in cardiac ICUs. There is a need for future research to empirically investigate these strategies.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 367-372"},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001638/pdfft?md5=abea6dd80c0b93c1d9e04fea1dbcd80b&pid=1-s2.0-S0147956324001638-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and internal validation of a predictive model for prolonged intensive care unit stays in patients with psychotropic drug poisoning","authors":"Qifang Shi ,&nbsp;Huishui Dai ,&nbsp;Gen Ba ,&nbsp;Meng Li ,&nbsp;Jinsong Zhang","doi":"10.1016/j.hrtlng.2024.09.003","DOIUrl":"10.1016/j.hrtlng.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><p>Some patients with psychotropic drug poisoning need intensive care unit (ICU) admission, but risk prediction models for prolonged ICU stays are lacking.</p></div><div><h3>Objectives</h3><p>Develop and evaluate a prediction model for prolonged ICU stays in patients with psychotropic drug poisoning.</p></div><div><h3>Methods</h3><p>The clinical data of patients with psychotropic drug poisoning were collected from the Medical Information Mart for Intensive Care (MIMIC)-Ⅳ 2.2 database. Patients were grouped by their ICU length of stay: non-prolonged (&lt;2 days) and prolonged (≥2 days).</p><p>Variable selection methods included LASSO and logistic regression. The selected variables were used to construct the model, which was subsequently evaluated for discrimination, calibration, and clinical utility.</p></div><div><h3>Results</h3><p>The cohort included 413 patients with psychotropic drug poisoning, 49.4 % male, with a median age of 41 years. The variables stepwise selected for model construction through LASSO and logistic regression include sepsis, SAPS Ⅱ, heart rate, respiratory rate, and mechanical ventilation. The model showed good discrimination with an area under the receiver operating characteristic curve (AUC) of 0.785 (95 % CI: 0.736–0.833) and was validated well with bootstrap internal validation (AUC: 0.792, 95 % CI: 0.745–0.839). Calibration curves indicated good fit (χ2 = 4.148, <em>P</em> = 0.844), aligning observed and predicted rates of prolonged ICU stays. Decision curve analysis (DCA) showed positive net benefits across a threshold probability range of 0.07–0.85.</p></div><div><h3>Conclusions</h3><p>The model developed in this study may help predict the risk of prolonged ICU stays for patients with psychotropic drug poisoning.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 350-358"},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between food environments and cardiovascular disease outcomes: A systematic review","authors":"Yu Jia Liu ,&nbsp;Xiao Qin Wang ,&nbsp;Guiqin Zhang ,&nbsp;Qiansheng Zhao ,&nbsp;Yu Xin Cheng ,&nbsp;Shuo Liu ,&nbsp;Bing Xiang Yang ,&nbsp;Dan Luo ,&nbsp;Qian Liu ,&nbsp;Huijing Zou","doi":"10.1016/j.hrtlng.2024.08.019","DOIUrl":"10.1016/j.hrtlng.2024.08.019","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular disease (CVD) is the leading cause of death worldwide, particularly affecting low- and middle-income countries. Food environments may be linked with the risk of CVD; however, current study findings regarding their relationship are inconsistent. A systematic review of their associations is needed to guide interventions to improve cardiovascular health.</p></div><div><h3>Objective</h3><p>This systematic review aimed to comprehensively assess the relationship between food environments and CVD outcomes, including incidence, hospitalization, mortality, and recurrence rates.</p></div><div><h3>Method</h3><p>According to PRISMA guidelines, a systematic search was conducted until 28th March 2024, using eight databases, including PubMed, Embase, Ovid, CINAHL, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data. The review quality was assessed according to the Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Scale (NOS). The included studies were categorized based on their exposure factors into unhealthy, healthy, and comprehensive food environments, encompassing facilities that offer healthy and unhealthy foods. The findings were narratively synthesized according to this classification.</p></div><div><h3>Result</h3><p>A total of 23 studies, encompassing 13 cross-sectional studies and 10 cohort-longitudinal studies, were included in this review. Among the 20 studies on unhealthy food environments, 13 found a positive association with CVD outcomes. Of the seven studies on healthy food environments, 3 found a negative association with CVD outcomes. Additionally, 4 out of 8 studies on comprehensive food environments found a significant but inconsistent association with CVD outcomes.</p></div><div><h3>Conclusion</h3><p>This study suggested that unhealthy food environments are probably associated with CVD outcomes. At the same time, there is currently no conclusive evidence to indicate a relationship between healthy food environments or comprehensive food environments and CVD outcomes.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 359-366"},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}