一家三级医院动脉血管手术患者的术前评估概况。

IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Clinics Pub Date : 2024-07-25 eCollection Date: 2024-01-01 DOI:10.1016/j.clinsp.2024.100445
Arthur Souza Magnani, Leandro Teixeira de Castro, Isabela Cristina Kirnew Abud Manta, Viviane Galli Dib, Luiz Otávio Vittorelli, Felipe Soares Oliveira Portela, Nelson Wolosker, Marcelo Passos Teivelis
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引用次数: 0

摘要

背景:外周动脉疾病患者在动脉手术后发生心血管并发症的风险增加,这些并发症被称为重大心脏不良事件(MACE),包括急性心肌梗死、心力衰竭、恶性心律失常和中风。术前评估旨在降低死亡率和 MACE 风险。然而,目前还没有标准化的评估方法。本研究旨在比较全科医生和心脏病专家进行的术前评估:这是一项对巴西圣保罗一家三级医院 2016 年 1 月至 2020 年 12 月期间接受择期动脉手术患者病历的回顾性分析。作者比较了根据初始评估者(全科医生与心脏病专家)对这些患者进行的术前评估,评估了患者的临床因素、死亡率、术后 MACE 发生率、要求进行无创分层检查的比例、住院时间等:结果:共对 281 名患者进行了评估:169 人由心脏病专家评估,112 人由全科医生评估。与全科医生(9%)相比,心脏病专家要求进行的无创分层检查更多(40.8%)(p < 0.001),但对死亡率(8.8% 对 10.7%;p = 0.609)和术后 MACE 发生率(10.6% 对 6.2%;p = 0.209)没有影响。结论:心脏科医生组的总住院时间更长(17.27 天对 11.79 天;P < 0.001):结论:增加检查要求对死亡率和术后MACE发生率没有显著影响,但延长了住院总时间。医疗管理人员应考虑这些研究结果,确保合理利用人力和财力资源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preoperative evaluation profile of patients undergoing arterial vascular surgery in a tertiary hospital.

Background: Patients with peripheral arterial disease have an increased risk of developing cardiovascular complications in the postoperative period of arterial surgeries known as Major Adverse Cardiac Events (MACE), which includes acute myocardial infarction, heart failure, malignant arrhythmias, and stroke. The preoperative evaluation aims to reduce mortality and the risk of MACE. However, there is no standardized approach to performing them. The aim of this study was to compare the preoperative evaluation conducted by general practitioners with those performed by cardiologists.

Methods: This is a retrospective analysis of medical records of patients who underwent elective arterial surgeries from January 2016 to December 2020 at a tertiary hospital in São Paulo, Brazil. The authors compared the preoperative evaluation of these patients according to the initial evaluator (general practitioners vs. cardiologists), assessing patients' clinical factors, mortality, postoperative MACE incidence, rate of requested non-invasive stratification tests, length of hospital stay, among others.

Results: 281 patients were evaluated: 169 assessed by cardiologists and 112 by general practitioners. Cardiologists requested more non-invasive stratification tests (40.8%) compared to general practitioners (9%) (p < 0.001), with no impact on mortality (8.8% versus 10.7%; p = 0.609) and postoperative MACE incidence (10.6% versus 6.2%; p = 0.209). The total length of hospital stay was longer in the cardiologist group (17.27 versus 11.79 days; p < 0.001).

Conclusion: The increased request for exams didn't have a significant impact on mortality and postoperative MACE incidence, but prolonged the total length of hospital stay. Health managers should consider these findings and ensure appropriate utilization of human and financial resources.

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来源期刊
Clinics
Clinics 医学-医学:内科
CiteScore
4.10
自引率
3.70%
发文量
129
审稿时长
52 days
期刊介绍: CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.
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