优化卒中和相关心脏病管理的综合护理:欧洲心脏病学会卒中委员会立场文件。

Integrated care for optimizing the management of stroke and associated heart disease: a position paper of the European Society of Cardiology Council on Stroke.

机构信息

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.

Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

出版信息

Eur Heart J. 2022 Jul 7;43(26):2442-2460. doi: 10.1093/eurheartj/ehac245.

Abstract

The management of patients with stroke is often multidisciplinary, involving various specialties and healthcare professionals. Given the common shared risk factors for stroke and cardiovascular disease, input may also be required from the cardiovascular teams, as well as patient caregivers and next-of-kin. Ultimately, the patient is central to all this, requiring a coordinated and uniform approach to the priorities of post-stroke management, which can be consistently implemented by different multidisciplinary healthcare professionals, as part of the patient 'journey' or 'patient pathway,' supported by appropriate education and tele-medicine approaches. All these aspects would ultimately aid delivery of care and improve patient (and caregiver) engagement and empowerment. Given the need to address the multidisciplinary approach to holistic or integrated care of patients with heart disease and stroke, the European Society of Cardiology Council on Stroke convened a Task Force, with the remit to propose a consensus on Integrated care management for optimizing the management of stroke and associated heart disease. The present position paper summarizes the available evidence and proposes consensus statements that may help to define evidence gaps and simple practical approaches to assist in everyday clinical practice. A post-stroke ABC pathway is proposed, as a more holistic approach to integrated stroke care, would include three pillars of management: A: Appropriate Antithrombotic therapy.B: Better functional and psychological status.C: Cardiovascular risk factors and Comorbidity optimization (including lifestyle changes).

摘要

脑卒中患者的管理通常是多学科的,涉及多个专业和医疗保健专业人员。鉴于脑卒中与心血管疾病的常见共同危险因素,心血管团队也可能需要提供意见,还需要患者护理人员和近亲的参与。最终,患者是所有这些的核心,需要对脑卒中管理的重点采取协调一致的统一方法,不同的多学科医疗保健专业人员可以作为患者“旅程”或“患者通道”的一部分,通过适当的教育和远程医疗方法,始终如一地实施这些方法。所有这些方面最终都将有助于提供护理,并提高患者(和护理人员)的参与度和赋权。鉴于需要解决针对心脏病和脑卒中患者的整体或综合护理的多学科方法,欧洲心脏病学会理事会中风委员会召集了一个工作组,其任务是就优化脑卒中及相关心脏病管理的综合护理管理提出共识。本立场文件总结了现有证据,并提出了共识声明,这些声明可能有助于确定证据差距和简单实用的方法,以协助日常临床实践。提出了脑卒中 ABC 途径,作为综合脑卒中护理的更全面方法,将包括三个管理支柱:A:适当的抗血栓治疗。B:更好的功能和心理状态。C:心血管风险因素和合并症的优化(包括生活方式的改变)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4d3/9259378/0c3e4c1f3a88/ehac245ga1.jpg

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