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多学科门诊心房颤动(AF)诊所是否会影响急性 AF 入院人数?一项回顾性队列研究。

Does an interdisciplinary outpatient atrial fibrillation (AF) clinic affect the number of acute AF admissions? A retrospective cohort study.

机构信息

Department of Cardiology, Odense University Hospital, Odense, Denmark.

出版信息

J Clin Nurs. 2018 Jul;27(13-14):2684-2690. doi: 10.1111/jocn.14373. Epub 2018 May 30.

Abstract

AIMS AND OBJECTIVES

To investigate the impact of a multidisciplinary outpatient clinic for patients with atrial fibrillation-clinic on the number of acute hospitalisations for atrial fibrillation compared with usual outpatient care for this condition before the establishment of the atrial fibrillation-clinic.

BACKGROUND

Guidelines recommend a structured outpatient clinic follow-up in multidisciplinary teams for patients with atrial fibrillation due to fewer hospitalisations and death. However, the evidence base is weak.

DESIGN

The study is a retrospective cohort study including a total of 129 patients from the cardiac outpatient clinic at a large Danish University Hospital. The study population consisted of two groups: a usual care group before a dedicated atrial fibrillation-clinic was established (n = 73) and the atrial fibrillation-clinic group (n = 56). The primary endpoint was acute hospitalisation for atrial fibrillation.

METHODS

Cox regression was used to assess the hazard ratio for acute hospitalisations for atrial fibrillation.

RESULTS

When comparing the atrial fibrillation-clinic with the usual care group, adjusted for age and sex, this study showed a trend towards more frequent acute hospitalisations in the usual care group.

CONCLUSION

The results of this study are hypothesis-generating and should lead to larger prospective trials to evaluate the impact of dedicated multidisciplinary atrial fibrillation-clinics on atrial fibrillation-related issues as acute hospitalisations for atrial fibrillation, symptoms and quality of life.

RELEVANCE TO CLINICAL PRACTICE

Follow-up in a dedicated multidisciplinary AF-clinic might empower patients better to cope with acute arrhythmia symptoms.

摘要

目的

调查与房颤门诊常规护理相比,多学科房颤门诊对房颤患者急性住院治疗数量的影响,房颤门诊建立前用于该疾病的常规护理。

背景

指南建议在多学科团队中对房颤患者进行结构化门诊随访,以减少住院和死亡。然而,证据基础薄弱。

设计

本研究是一项回顾性队列研究,共纳入了丹麦一家大型大学医院心脏门诊的 129 名患者。研究人群分为两组:在专门的房颤门诊建立之前的常规护理组(n=73)和房颤门诊组(n=56)。主要终点是房颤急性住院治疗。

方法

使用 Cox 回归评估房颤急性住院的风险比。

结果

与常规护理组相比,调整年龄和性别后,房颤门诊组的急性住院治疗频率呈上升趋势,但无统计学意义。

结论

本研究结果具有启发性,应开展更大规模的前瞻性试验,以评估专门的多学科房颤门诊对房颤相关问题(如房颤急性住院治疗、症状和生活质量)的影响。

临床相关性

在专门的多学科房颤门诊进行随访可能会使患者更好地应对急性心律失常症状。

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