• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Canadian Journal of Emergency Medicine >Implementation of an emergency department atrial fibrillation and flutter pathway improves rates of appropriate anticoagulation, reduces length of stay and thirty-day revisit rates for congestive heart failure
【24h】

Implementation of an emergency department atrial fibrillation and flutter pathway improves rates of appropriate anticoagulation, reduces length of stay and thirty-day revisit rates for congestive heart failure

机译：实施急诊室房颤和扑动通路可提高适当的抗凝率，缩短住院时间，并为充血性心力衰竭提供30天复诊率

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

ObjectivesAn evidence-based emergency department (ED) atrial fibrillation and flutter (AFF) pathway was developed to improve care. The primary objective was to measure rates of new anticoagulation (AC) on ED discharge for AFF patients who were not AC correctly upon presentation.MethodsThis is a pre-post evaluation from April to December 2013 measuring the impact of our pathway on rates of new AC and other performance measures in patients with uncomplicated AFF solely managed by emergency physicians. A standardized chart review identified demographics, comorbidities, and ED treatments. The primary outcome was the rate of new AC. Secondary outcomes were ED length of stay (LOS), referrals to AFF clinic, ED revisit rates, and 30-day rates of return visits for congestive heart failure (CHF), stroke, major bleeding, and death.ResultsED AFF patients totalling 301 (129 pre-pathway [PRE]; 172 post-pathway [POST]) were included; baseline demographics were similar between groups. The rates of AC at ED presentation were 18.6% (PRE) and 19.7% (POST). The rates of new AC on ED discharge were 48.6 % PRE (95% confidence interval [CI] 42.1%-55.1%) and 70.2% POST (62.1%-78.3%) (20.6% [p&0.01; 15.1-26.3]). Median ED LOS decreased from 262 to 218 minutes (44 minutes [p&0.03; 36.2-51.8]). Thirty-day rates of ED revisits for CHF decreased from 13.2% to 2.3% (10.9%; p&0.01; 8.1%-13.7%), and rates of other measures were similar.ConclusionsThe evidence-based pathway led to an improvement in the rate of patients with new AC upon discharge, a reduction in ED LOS, and decreased revisit rates for CHF.
机译：目的建立循证急诊室颤动和扑动途径以改善护理。方法的主要目的是为2013年4月至2013年12月进行的事前评估，评估我们的途径对新AC发生率的影响。以及由急诊医师单独管理的单纯性AFF患者的其他表现指标。标准化的图表审查确定了人口统计学，合并症和急诊治疗。主要结果是新AC的发生率。次要结局为ED住院时间（LOS），转诊至AFF诊所，ED复诊率以及30天因充血性心力衰竭（CHF），中风，大出血和死亡而回访率。结果ED AFF患者总计301（纳入了129个路径前[PRE]; 172个路径后[POST]）;两组之间的基线人口统计学相似。急诊就诊时的AC率为18.6％（PRE）和19.7％（POST）。 ED放电时新AC的发生率为48.6％PRE（95％置信区间[CI] 42.1％-55.1％）和70.2％POST（62.1％-78.3％）（20.6％[p <0.01; 15.1-26.3]） 。 ED LOS中值从262分钟减少到218分钟（44分钟[p <0.03; 36.2-51.8]）。 ED对CHF的30天重访率从13.2％降至2.3％（10.9％; p <0.01; 8.1％-13.7％），其他措施的发生率也相似。出院时出现新AC的患者的比率，ED LOS的降低以及CHF的再次访视率降低。

著录项

相似文献

  • 外文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号