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急性心肌梗死患者的睡眠质量与不良结局

Sleep quality and adverse outcomes for patients with acute myocardial infarction.

作者信息

Andrechuk Carla Renata Silva, Ceolim Maria Filomena

机构信息

Faculty of Nursing, Campinas State University, Campinas, SP, Brazil.

出版信息

J Clin Nurs. 2016 Jan;25(1-2):223-30. doi: 10.1111/jocn.13051.

Abstract

AIMS AND OBJECTIVES

This study aimed to analyse the relationship between the worsening of clinical outcomes (cardiovascular death, recurrent cardiovascular ischaemic events and stroke) and sleep quality, daytime sleepiness and risk for obstructive sleep apnoea syndrome in patients admitted to cardiac care units due to an acute myocardial infarction.

BACKGROUND

There is evidence that sleep disorders can contribute to the worsening of cardiovascular diseases.

DESIGN

This is a descriptive study with follow-up.

METHODS

Data collection was conducted in a large university hospital in Brazil from October 2013 to March 2014. Patients admitted with acute myocardial infarction provided data about sleep quality, daytime sleepiness and risk factors for obstructive sleep apnoea syndrome by answering specific questionnaires. Clinical data were obtained from medical charts. Data were analysed with descriptive statistics and multiple logistic regression models.

RESULTS

The worsening of clinical outcome occurred in 12·4% of patients and was independently associated to poor sleep quality.

CONCLUSION

Poor sleep quality, excessive daytime sleepiness and high risk for obstructive sleep apnoea syndrome were frequent in hospitalised patients with acute myocardial infarction and affect negatively the process of recovery.

RELEVANCE TO CLINICAL PRACTICE

It is important to evaluate sleep quality and sleep disorders, aiming at preventing and reducing unfavourable outcomes of cardiovascular disease, particularly for acute myocardial infarction patients.

摘要

目的与目标

本研究旨在分析因急性心肌梗死入住心脏监护病房的患者临床结局恶化(心血管死亡、复发性心血管缺血事件和中风)与睡眠质量、日间嗜睡及阻塞性睡眠呼吸暂停低通气综合征风险之间的关系。

背景

有证据表明睡眠障碍会促使心血管疾病恶化。

设计

这是一项有随访的描述性研究。

方法

2013年10月至2014年3月在巴西一家大型大学医院进行数据收集。因急性心肌梗死入院的患者通过回答特定问卷提供有关睡眠质量、日间嗜睡及阻塞性睡眠呼吸暂停低通气综合征危险因素的数据。临床数据从病历中获取。数据采用描述性统计和多元逻辑回归模型进行分析。

结果

12.4%的患者临床结局恶化,且与睡眠质量差独立相关。

结论

急性心肌梗死住院患者中,睡眠质量差、日间过度嗜睡及阻塞性睡眠呼吸暂停低通气综合征高风险情况常见,且对恢复过程有负面影响。

与临床实践的相关性

评估睡眠质量和睡眠障碍很重要,目的是预防和减少心血管疾病的不良结局,尤其是对急性心肌梗死患者。

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