University of Adelaide, Adelaide, Australia; Gold Coast University Hospital, Southport, Australia.
University of Adelaide, Adelaide, Australia.
Cardiovasc Revasc Med. 2023 Jul;52:94-98. doi: 10.1016/j.carrev.2023.03.016. Epub 2023 Mar 24.
Clear and effective communication is vital in discussions regarding coronary revascularization. Language barriers may limit communication in healthcare settings. Previous studies on the influence of language barriers on the outcomes of patients receiving coronary revascularization have produced conflicting results. The aim of this systematic review was to evaluate and synthesise the existing evidence regarding the effects of language barrier on the outcomes of patients receiving coronary revascularization.
A systematic review was conducted, including a search of the PubMed, EMBASE, Cochrane, and Google Scholar databases on 01/10/2022. The review was conducted in accordance with PRISMA guidelines. This review was also prospectively registered on PROSPERO.
Searches identified 3983 articles of which a total 12 studies were included in the review. Most studies describe that language barriers result in delayed presentation, but not delays in treatment following hospital arrival with respect to coronary revascularization. The findings with respect to the likelihood of receiving revascularization have varied significantly; however, some studies have indicated that those with language barriers may be less likely to receive revascularization. There have been some conflicting results with respect to the association between language barrier and mortality. However, most studies suggest that there is no association with increased mortality. In studies that evaluated length of stay variable results have been reported based on geographical location. Namely Australian studies have suggested no association between language barrier and length of stay, but Canadian studies support an association. Language barriers may also be associated with readmissions following discharge, and major adverse cardiovascular and cerebrovascular events (MACCE).
This study demonstrates that patients with language barriers may have poorer outcomes from coronary revascularization. Future interventional studies will be required to consider the sociocultural context of patients with language barriers, and may be targeted at timepoints including prior to, during, or after hospitalisation for coronary revascularization. Further examination of the adverse health outcomes of those with language barriers in fields outside of coronary revascularization are required in view of the stark inequities identified in this field.
在讨论冠状动脉血运重建时，清晰有效的沟通至关重要。语言障碍可能会限制医疗保健环境中的交流。之前关于语言障碍对接受冠状动脉血运重建患者结局影响的研究结果相互矛盾。本系统评价的目的是评估和综合现有关于语言障碍对接受冠状动脉血运重建患者结局影响的证据。
系统检索了 2022 年 10 月 1 日之前 PubMed、EMBASE、Cochrane 和 Google Scholar 数据库，检索策略包括关键词和 MeSH 主题词，对纳入的研究进行质量评价。
共检索到 3983 篇文献，最终纳入 12 项研究。大多数研究表明，语言障碍导致延迟就诊，但不会延迟入院后冠状动脉血运重建的治疗。关于接受血运重建的可能性的研究结果差异很大；然而，一些研究表明，语言障碍者接受血运重建的可能性较低。语言障碍与死亡率之间的关联存在一些相互矛盾的结果。然而，大多数研究表明，语言障碍与死亡率增加无关。在评估住院时间的研究中，基于地理位置报告了不同的结果。即澳大利亚的研究表明，语言障碍与住院时间之间没有关联，但加拿大的研究支持两者之间存在关联。语言障碍也可能与出院后的再入院和主要不良心血管和脑血管事件（MACCE）有关。
本研究表明，语言障碍患者可能在冠状动脉血运重建方面的结局较差。未来的干预性研究将需要考虑语言障碍患者的社会文化背景，并且可能针对包括在冠状动脉血运重建之前、期间或之后的时间点。鉴于在该领域发现了明显的不平等现象，需要进一步检查语言障碍者在冠状动脉血运重建以外领域的不良健康结局。
