中国某大型教学医院房颤中心对房颤更好护理整体路径实施的影响:中断时间序列分析

IF 4.4 Q1 HEALTH CARE SCIENCES & SERVICES
Pengze Xiao, Zhongqiu Chen, Zhi Zeng, Shu Su, Sihang Chen, Yufu Li, Xinyue Li, Xian Yang, Haoxuan Zhang, Yuehui Yin, Yunlin Chen, Zhiyu Ling
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引用次数: 0

摘要

目的:房颤(AF)因其复杂性需要综合治疗。2020年欧洲心脏病学会指南中引入的房颤更好治疗(ABC)途径已显示出临床益处,但依从性仍不理想。本研究评估了在中国教学医院建立心房颤动中心(AFC)对ABC通路依从性的影响。方法:本研究采用中断时间序列分析来评估AFC构建前后每月ABC通路依从率。分析重点是抗凝(A),更好的症状控制(B)和合并症管理(C)。结果:AFC建立后,全院ABC依从率上升11.82%,每月持续上升0.27%。改善主要发生在心脏病科和内科,而外科的变化很小。抗凝和症状控制依从性显著改善,而合并症管理保持不变。讨论:AFC通过标准化、多学科的AF管理提高了ABC通路的依从性。观察到抗凝和症状控制方面的显著改善,但节律控制和合并症管理仍然不理想。障碍包括有限的消融通道和分散的护理。未来的努力应加强跨学科合作,扩大程序可及性,并整合长期心血管风险管理,以优化房颤护理。结论:建立AFC可显著提高ABC通路的依从性,对卒中预防和症状管理均有效,特别是在心内科和内科。未来的努力应集中在加强心律控制策略和优化合并症管理,以进一步提高房颤的综合护理。试验注册号:MR-50-24-014759。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Impact of atrial fibrillation centre on the implementation of the atrial fibrillation better care holistic pathway in a Chinese large teaching hospital: an interrupted time series analysis.

Impact of atrial fibrillation centre on the implementation of the atrial fibrillation better care holistic pathway in a Chinese large teaching hospital: an interrupted time series analysis.

Impact of atrial fibrillation centre on the implementation of the atrial fibrillation better care holistic pathway in a Chinese large teaching hospital: an interrupted time series analysis.

Impact of atrial fibrillation centre on the implementation of the atrial fibrillation better care holistic pathway in a Chinese large teaching hospital: an interrupted time series analysis.

Objectives: Atrial fibrillation (AF) requires comprehensive management due to its complex nature. The Atrial Fibrillation Better Care (ABC) pathway, introduced in the 2020 European Society of Cardiology Guidelines, has demonstrated clinical benefits, yet adherence remains suboptimal. This study evaluates the impact of establishing an Atrial Fibrillation Centre (AFC) on ABC pathway adherence in a Chinese teaching hospital.

Methods: This study employed an interrupted time series analysis to assess monthly ABC pathway adherence rates before and after AFC construction. The analysis focused on anticoagulation (A), better symptom control (B) and comorbidity management (C).

Results: Following AFC establishment, the hospital-wide ABC adherence rate increased by 11.82%, with a sustained monthly increase of 0.27%. Improvements were primarily observed in cardiology and internal medicine departments, whereas surgical departments showed minimal change. Anticoagulation and symptom control adherence improved significantly, while comorbidity management remained unchanged.

Discussion: The AFC improved ABC pathway adherence through standardised, multidisciplinary AF management. Significant gains in anticoagulation and symptom control were observed, but rhythm control and comorbidity management remained suboptimal. Barriers include limited ablation access and fragmented care. Future efforts should enhance interdisciplinary collaboration, expand procedural accessibility and integrate long-term cardiovascular risk management to optimise AF care.

Conclusion: Establishing an AFC significantly improved ABC pathway adherence, which proved effective in both stroke prevention and symptom management, particularly in cardiology and internal medicine departments. Future efforts should focus on enhancing rhythm control strategies and optimising comorbidity management to further improve integrated AF care.

Trial registration number: MR-50-24-014759.

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来源期刊
CiteScore
6.10
自引率
4.90%
发文量
40
审稿时长
18 weeks
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