Heart & Lung最新文献

{"title":"Cardiovascular complications in the course of COVID-19 - lessons learned and implications for the future care of patients with viral respiratory diseases: Data from a single center retrospective observational study","authors":"Dominika Krogulec ,&nbsp;Carlo Bieńkowski ,&nbsp;Justyna D. Kowalska ,&nbsp;Agnieszka Bednarska ,&nbsp;Beata Wojtycha-Kwaśnica ,&nbsp;Natalia Jurek ,&nbsp;Piotr Ząbek ,&nbsp;Hanna Czeszko-Paprocka ,&nbsp;Monika Mrozińska ,&nbsp;Marcin Paciorek ,&nbsp;Andrzej Pihowicz ,&nbsp;Andrzej Horban","doi":"10.1016/j.hrtlng.2024.06.009","DOIUrl":"10.1016/j.hrtlng.2024.06.009","url":null,"abstract":"<div><h3>Background</h3><p>Factors associated with cardiovascular complications of COVID-19 remain understudied.</p></div><div><h3>Objectives</h3><p>Here we investigate the occurrence and risk factors of arrythmias, myocardial infarction and/or stroke, and thromboembolism in the course of COVID-19.</p></div><div><h3>Methods</h3><p>We have performed an observational study with prospectively designed data collection. Data of patients diagnosed with COVID-19 who were admitted from March 6th 2020 to November 30th 2021 in our Hospital were analyzed. Logistic regression was used to identify variables associated with the odds of early hospital death due to COVID-19.</p></div><div><h3>Results</h3><p>Fourteen-point three percent of 1964 patients had cardiovascular complications, 6.36 % arrhythmias, 5.5 % thromboembolic events and 2.39 % myocardial infarction and/or stroke. Factors independently increasing the odds of arrhythmia were older age (OR=1.49 [95 % CI: 1.17–1.92], <em>p</em> = 0.02), longer time between admission and the first onset of symptoms (1.02 [0.99–1.05], <em>p</em> = 0.049), concomitant atrial fibrillation/flutter (2.84 [1.37–5.70], <em>p</em> = 0.004), nicotinism (2.49 [1.37–4.49], <em>p</em> = 0.002), and eGFR&lt;60 ml/min/1.73m² (2.44 [1.08–5.59], <em>p</em> = 0.033). Factors independently increasing the odds of myocardial infarction and/or stroke were dementia (4.55 [0.97–19.3], <em>p</em> = 0.044), hemiplegia (12.67 [3.12–46.1], <em>p</em> &lt; 0.001), nicotinism (3.36 [1.30–10.4], <em>p</em> = 0.013) and higher C-reactive protein concentration (1.01 [1.00–1.01], <em>p</em> = 0.040). Factors independently increasing the odds of thromboembolic events were longer hospitalization (1.08 [1.05–1.10], <em>p</em> &lt; 0.001) and higher d-dimers (1.04 [1.02–1.05], &lt;0.001).</p></div><div><h3>Conclusions</h3><p>The risk of cardiovascular complications was especially pronounced in patients with older age, pre-existing cardiovascular disease and more sever pneumonia at presentation to care. This underlines the importance of close and careful clinical follow-up in the course of COVID-19 for specific patients’ populations, including a pro-active approach in diagnosis.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 116-125"},"PeriodicalIF":2.4,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001171/pdfft?md5=4e8f234ff8ab86049b7b594b4da96895&pid=1-s2.0-S0147956324001171-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472718","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":"Board of Directors","authors":"","doi":"10.1016/S0147-9563(24)00106-7","DOIUrl":"https://doi.org/10.1016/S0147-9563(24)00106-7","url":null,"abstract":"","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"67 ","pages":"Page v"},"PeriodicalIF":2.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001067/pdfft?md5=bcdf087f282a0751c8668e4778b5460d&pid=1-s2.0-S0147956324001067-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480988","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":"Association between oxidative balance score and heart failure in the older adults: Results from the NHANES 2005–2018","authors":"Jian Jia ,&nbsp;Zhonghua Sun ,&nbsp;Xinyu Tao ,&nbsp;Yanli Tong ,&nbsp;Han Feng ,&nbsp;Jiahui Yang ,&nbsp;Xiang Lu ,&nbsp;Chen Qu ,&nbsp;Zhengxia Liu ,&nbsp;Jun Wu","doi":"10.1016/j.hrtlng.2024.06.006","DOIUrl":"10.1016/j.hrtlng.2024.06.006","url":null,"abstract":"<div><h3>Background</h3><p>Heart failure (HF) imposes a substantial burden on older adults, and healthy diets and lifestyles may bring with benefits. However, quantifiable studies on the dietary and lifestyle risk factors for HF are scant. The Oxidative Balance Score (OBS) reflects the oxidative stress status of dietary components and lifestyle factors, but its relationship with HF risk is unclear.</p></div><div><h3>Objective</h3><p>We aims to explore the association between OBS and the prevalence of HF.</p></div><div><h3>Methods</h3><p>Using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2018, the association between OBS and the HF prevalence was analyzed by weighted logistic regression and restricted cubic splines (RCS). Subgroup and sensitivity analyses assessed the stability of the results.</p></div><div><h3>Results</h3><p>The prevalence of HF in the cohort of 6238 older adults was 5.55 %. Compared to the lowest quintile, the adjusted ORs for HF in the highest quintile of OBS and lifestyle OBS were 0.57 (95 % CI: 0.33,0.97) and 0.21 (95 %CI: 0.09,0.50), respectively. The association between OBS and HF prevalence remained stable across different models and subgroups. RCS revealed a potential inflection point. Sensitivity analysis validated the negative association between OBS and HF prevalence, and the correlation analysis between OBS and serum γ-glutamyltransferase (γ-GGT) confirmed the reliability of the study design.</p></div><div><h3>Conclusion</h3><p>The OBS is negatively associated with HF prevalence in older adults, and may help prevent HF in this population.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 107-115"},"PeriodicalIF":2.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001134/pdfft?md5=a9708328ee67270b370c4c4e6fb14f02&pid=1-s2.0-S0147956324001134-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472815","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 impact of forced awakening on morning blood pressure surge","authors":"Yeonsu Kim PhD, BSN, RN ,&nbsp;Jill Howie Esquivel PhD, RN, NP ,&nbsp;Meghan Kathleen Mattos PhD, RN, CNL ,&nbsp;Eric M. Davis MD ,&nbsp;Jeongok Logan PhD, MSN, RN","doi":"10.1016/j.hrtlng.2024.06.011","DOIUrl":"10.1016/j.hrtlng.2024.06.011","url":null,"abstract":"<div><h3>Background</h3><p>Poor sleep quality can cause an increase in morning blood pressure surge (MBPS), an independent risk factor of cardiovascular disease (CVD) events. Awakening induced by external factors such as alarm clocks, may also contribute to increased MBPS.</p></div><div><h3>Objectives</h3><p>To (1) compare the MBPS and sleep quality parameters between natural and forced awakenings and (2) examine the potential impact of forced awakening on MBPS, independent of sleep quality.</p></div><div><h3>Methods</h3><p>Thirty-two healthy adults participated in this pilot study, which included one night of natural awakening and one night of forced awakening (i.e., sleep was interrupted by an alarm after five hours). Objective and self-reported sleep quality parameters were measured using a multisensory wristband and sleep diaries, respectively, and beat-to-beat blood pressure variability was assessed using a continuous blood pressure monitor. Analyses included a paired <em>t</em>-test (objective 1) and linear mixed models (objective 2).</p></div><div><h3>Results</h3><p>Participants predominantly consisted of young, healthy, and highly educated Asian adults. During the night of sleep with forced awakening, significantly higher MBPS, lower objective wakefulness after sleep onset, and lower self-reported sleep latency were observed, compared to the night with natural awakening. Forced awakening was significantly associated with increased MBPS after controlling for age, sex, mean arterial pressure, and sleep quality.</p></div><div><h3>Conclusions</h3><p>Forced awakening may significantly increase MBPS, consequently heightening the risk of CVD events. Study findings should be validated in a larger sample. Further research is also warranted to examine the impact of forced awakening on MBPS in individuals with CVD.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 92-97"},"PeriodicalIF":2.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472721","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":"Exploration of COVID-19 associated bradycardia using heart rate variability analysis in a case-control study of ARDS patients","authors":"Hugo Dumargne ,&nbsp;Hugues Patural ,&nbsp;François Charbonnieras ,&nbsp;David Charier ,&nbsp;Charlotte Biscarrat ,&nbsp;Matthieu Chivot ,&nbsp;Laurent Argaud ,&nbsp;Martin Cour ,&nbsp;Auguste Dargent","doi":"10.1016/j.hrtlng.2024.06.014","DOIUrl":"10.1016/j.hrtlng.2024.06.014","url":null,"abstract":"<div><h3>Background</h3><p>Bradycardia and dysautonomia observed during SARS-Cov2 infection suggests involvement of the autonomic nervous system (ANS). Limited data exists on ANS dysregulation and its association with outcomes in patients with acute respiratory distress syndrome (ARDS) related to COVID-19 (C-ARDS) or other etiologies (NC-ARDS).</p></div><div><h3>Objectives</h3><p>We aimed to explore sympathovagal balance, assessed by heart rate variability (HRV), and its clinical prognostic value in C-ARDS compared with NC-ARDS.</p></div><div><h3>Methods</h3><p>A single-center, prospective case-control study was conducted. Consecutive patients meeting ARDS criteria between 2020 and 2022 were included. HRV was assessed using 1-hour electrographic tracing during a stable, daytime period.</p></div><div><h3>Results</h3><p>Twenty-four patients with C-ARDS and 19 with NC-ARDS were included. Age, sex and ARDS severity were similar between groups. The median heart rate was markedly lower in the C-ARDS group than in the NC-ARDS group (60 [53–72] versus 101 [91–112] bpm, <em>p</em>&lt;.001). Most of HRV parameters were significantly increased in patients with C-ARDS. HRV correlated with heart rate only in patients with C-ARDS. A positive correlation was found between the low-to high-frequency ratio (LF/HF) and length of intensive care unit stay (<em>r</em> = 0.576, <em>p</em>&lt;.001).</p></div><div><h3>Conclusion</h3><p>This study confirmed that C-ARDS was associated with marked bradycardia and severe ANS impairment, suggesting a sympathovagal imbalance with vagal overtone. Poor outcomes appeared to be more related to sympathetic rather than parasympathetic hyperactivation.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 74-80"},"PeriodicalIF":2.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001225/pdfft?md5=ae5c163824fc14678624c7d435ceab17&pid=1-s2.0-S0147956324001225-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472719","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":"Respiratory, cardiovascular and musculoskeletal mechanisms involved in the pathophysiology of pulmonary hypertension: An updated systematic review of preclinical and clinical studies","authors":"Thaís C Freire ,&nbsp;Marília S Ferreira ,&nbsp;Kátia De Angelis ,&nbsp;Marcelle Paula-Ribeiro","doi":"10.1016/j.hrtlng.2024.06.001","DOIUrl":"10.1016/j.hrtlng.2024.06.001","url":null,"abstract":"<div><p>Background: Progressive exercise intolerance is a hallmark of pulmonary hypertension (pH), severely impacting patients' independence and quality of life (QoL). Accumulating evidence over the last decade shows that combined abnormalities in peripheral reflexes and target organs contribute to disease progression and exercise intolerance. Objective: The aim of this study was to review the literature of the last decade on the contribution of the cardiovascular, respiratory, and musculoskeletal systems to pathophysiology and exercise intolerance in pH. Methods: A systematic literature search was conducted using specific terms in PubMed, SciELO, and the Cochrane Library databases for original pre-clinical or clinical studies published between 2013 and 2023. Studies followed randomized controlled/non-randomized controlled and pre-post designs. Results: The systematic review identified 25 articles reporting functional or structural changes in the respiratory, cardiovascular, and musculoskeletal systems in pH. Moreover, altered biomarkers in these systems, lower cardiac baroreflex, and heightened peripheral chemoreflex activity seemed to contribute to functional changes associated with poor prognosis and exercise intolerance in pH. Potential therapeutic strategies acutely explored involved manipulating the baroreflex and peripheral chemoreflex, improving cardiovascular autonomic control via cardiac vagal control, and targeting specific pathways such as GPER1, GDF-15, miR-126, and the JMJD1C gene. Conclusion: Information published in the last 10 years advances the notion that pH pathophysiology involves functional and structural changes in the respiratory, cardiovascular, and musculoskeletal systems and their integration with peripheral reflexes. These findings suggest potential therapeutic targets, yet unexplored in clinical trials, that could assist in improving exercise tolerance and QoL in patients with pH.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 81-91"},"PeriodicalIF":2.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472720","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 effect of single-limb exercises on functional exercise capacity, pulmonary function and dyspnea in patients with COPD","authors":"Alper Kemal Gürbüz ,&nbsp;Aynur Demirel","doi":"10.1016/j.hrtlng.2024.06.004","DOIUrl":"10.1016/j.hrtlng.2024.06.004","url":null,"abstract":"<div><h3>Background</h3><p>Aeorobic exercise is an essential component of the pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD). Single-limb exercises are a type of aeorobic exercise that aims to increase patient tolerance by reducing the workload of the respiratory system.</p></div><div><h3>Objektives</h3><p>The aim of our systematic review was to determine the effects of single-limb exercises on pulmonary function, dyspnea, fatigue, and muscle dysfunction in patients with COPD.</p></div><div><h3>Methods</h3><p>Searches were performed using PubMed, Pedro, Google Scholar, MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science databases. Publications from the beginning to 2023 searched. Studies were selected by two authors by scanning the title, Mesh terms abstract in Rayyan QCRI software. Selected studies were subjected to full-text screening by applying selection criteria. Randomized controlled, case-control, cohort studies were included.</p></div><div><h3>Results</h3><p>In the first screening according to mesh terms, 1011 articles were identified. After the screening criteria and duplicate articles were evaluated, 10 articles were included. This systematic review includes seven case-control, one randomized control trial (RCT), one cross-sectional, and one non-randomized study. A total of 157 patients with COPD received treatment in these studies. According to the Bakker scale, single-limb exercises have been shown to improve pulmonary function with strong evidence. There is strong evidence that single-limb exercises have no effect on dyspnea and fatigue in COPD patients. There is limited evidence that single-limb exercises have an effect on functional exercise capacity.</p></div><div><h3>Conclusion</h3><p>Single-limb exercise can advised in terms of improving pulmonary function in patients with COPD. Current systematic review has found single limb exercise has no effect on dyspnea and fatigue perception. No side effects were reported in the studies and these exercises can be considered safe.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 98-106"},"PeriodicalIF":2.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472716","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":"BMI moderates the relationship between depression and chronic obstructive pulmonary disease: A cross‑sectional survey","authors":"Feng Wang,&nbsp;Liangliang Jia","doi":"10.1016/j.hrtlng.2024.06.013","DOIUrl":"10.1016/j.hrtlng.2024.06.013","url":null,"abstract":"<div><h3>Background</h3><p>Prior research has established a connection between depression and chronic obstructive pulmonary disease (COPD). However, the influence of age and BMI on this association remains unclear.</p></div><div><h3>Objectives</h3><p>We used the National Health and Nutrition Examination Survey (NHANES) database to explore the relationship between depression and COPD, and to investigate whether age and Body mass index (BMI) act as moderators in this relationship.</p></div><div><h3>Methods</h3><p>We analyzed data from 10,940 participants in the NHANES database. Depression served as the independent variable. COPD status served as the outcome variable. We employed multivariable logistic regression to examine the relationship between depression and COPD.</p></div><div><h3>Results</h3><p>Of the 10,940 respondents surveyed, about 3.9 % had COPD and 8.5 % had depression. The prevalence of depression in COPD patients was significantly greater than the prevalence of overall respondents (21.1 % VS.8.5 %). We found that the association between depression and COPD was mediated by BMI status. Controlling for other covariates, the association between depression and COPD increased significantly. For the underweight group, the impact of depression on the risk of COPD was lower compared to the normal BMI group.</p></div><div><h3>Conclusion</h3><p>This study confirms a significant association between depression and COPD, with BMI serving as a moderator. These findings enhance our understanding of the complex interplay between depression and COPD and underscore the importance of considering individual physical health characteristics in clinical assessments. The results have significant implications for clinical practice and public health policymaking.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 68-73"},"PeriodicalIF":2.4,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472717","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":"Prognostic performance of the SCAI shock classification at admission and during ICU treatment: A retrospective, observational cohort study","authors":"Simone Britsch ,&nbsp;Markward Britsch ,&nbsp;Leonie Hahn ,&nbsp;Harald Langer ,&nbsp;Simon Lindner ,&nbsp;Ibrahim Akin ,&nbsp;Thomas Helbing ,&nbsp;Daniel Duerschmied ,&nbsp;Tobias Becher","doi":"10.1016/j.hrtlng.2024.06.012","DOIUrl":"10.1016/j.hrtlng.2024.06.012","url":null,"abstract":"<div><h3>Background</h3><p>Cardiogenic shock (CS) is characterized by high mortality and requires accurate prognostic tools to predict outcomes and guide treatment. The Society for Cardiovascular Angiography and Interventions (SCAI) shock classification indicates shock severity and can be used for outcome prediction.</p></div><div><h3>Objective</h3><p>Here, we compare the prognostic performance of SCAI shock classification determined on admission and during intensive care unit (ICU) stay.</p></div><div><h3>Methods</h3><p>We included all patients with CS or conditions associated with developing CS based on ICD codes. SCAI shock stages were determined on admission and during the first 5 days of ICU stay. Receiver operating curves were used to compare the prognostic performance of SCAI stages on admission, SCAI stages during ICU stay and CS evolution (absent, resolved, persistent and new onset) for in-hospital mortality.</p></div><div><h3>Results</h3><p>Between 01/2018 and 06/2022, 1303 patients were identified and 862 patients were included. On admission, 50.6 % patients had SCAI shock stage A, 3.9 % SCAI shock stage B, 17.7 % SCAI shock stage C, 7.0 % SCAI shock stage D and 20.8 % SCAI shock stage E. Shock stage distribution changed dynamically during ICU stay. Compared to SCAI stage on admission (AUC 0.80; 95 % CI 0.77–0.83), highest achieved SCAI stage during ICU (AUC 0.86, 95 % CI 0.83–0.89, <em>p</em> &lt; 0.0001) and shock evolution (AUC 0.87, 95 % CI 0.85–0.90, <em>p</em> &lt; 0.0001) yielded better prognostic performance.</p></div><div><h3>Conclusions</h3><p>SCAI shock stages changed dynamically during ICU stay, and prognostic performance can be improved by considering highest achieved SCAI shock stage as well as the evolution of CS compared to SCAI shock stage on admission.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 52-59"},"PeriodicalIF":2.4,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460828","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":"Impact of triage nurses' recognition of acute coronary syndrome on patients' clinical outcomes: A retrospective study","authors":"Anas Alsharawneh PhD, RN ,&nbsp;Murad Sawalha PhD, RN ,&nbsp;Nazih Abu Tabar PhD, RN ,&nbsp;Rami A. Elshatarat PhD, RN ,&nbsp;Abdulaziz Mofdy Almarwani PhD, RN ,&nbsp;Zyad T. Saleh PhD, RN ,&nbsp;Wesam T. Almagharbeh PhD, RN ,&nbsp;Hekmat Y. Al-Akash PhD, RN ,&nbsp;Nermen A. Mohamed PhD, RN ,&nbsp;Mudathir M. Eltayeb PhD, RN","doi":"10.1016/j.hrtlng.2024.06.010","DOIUrl":"10.1016/j.hrtlng.2024.06.010","url":null,"abstract":"<div><h3>Background</h3><p>Triage nurses' pivotal role in initial assessment makes their competence crucial. However, the specific impact on Acute Coronary Syndrome (ACS) recognition and outcomes remains unclear in Jordanian healthcare. Understanding this relationship could enhance ACS management and patient outcomes in Jordanian Emergency Departments (EDs).</p></div><div><h3>Objective</h3><p>To assess how triage nurses' recognition of ACS diagnosis affects patient outcomes in Jordan.</p></div><div><h3>Methods</h3><p>This retrospective study examined records of 150 ACS patients admitted to the coronary care unit (CCU). Data extraction assessed triage nurses' accuracy in recognizing ACS symptoms and the timelines for diagnosis procedures (e.g., electrocardiogram [ECG]) and treatment provision (e.g., thrombolytic) based on triage decisions. It also evaluated the impact on treatment outcomes, including length of stay in the ED and hospital. Multiple linear regression analyses quantified the influence of under-triage on treatment outcomes.</p></div><div><h3>Results</h3><p>The sample comprised 150 patients. Most were female (78.7%), aged 45-59.9 years (37.3%). ACS classifications: unstable angina (52.0%), STEMI (38.0%), NSTEMI (10.0%). The study included a cohort of ACS patients, with findings indicating varying degrees of under-triage by triage nurses. Analysis of timelines revealed significant delays in diagnosis and treatment initiation for patients subjected to under-triage. Multiple linear regression analyses demonstrated a robust association between under-triage and prolonged time to essential treatment outcomes, including delays in physician assessment, ECG performance, thrombolytic administration, and extended ED length of stay.</p></div><div><h3>Conclusion</h3><p>Triage nurses' knowledge and competency are crucial determinants of accurate ACS recognition and subsequent clinical outcomes for patients presenting to the ED in Jordan. Investing in ongoing education and training programs for triage nurses may lead to improved ACS recognition rates and better patient outcomes in Jordanian healthcare settings.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 60-67"},"PeriodicalIF":2.4,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460827","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}