Reach and effectiveness of a non-university cardio-obstetrics program.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-12-01 Epub Date: 2024-06-23 DOI:10.1080/14767058.2024.2367090

Retu Saxena, Gretchen Benson, Abbey C Sidebottom, Brynn Okeson, Joy Hayes, Kirsten Shaw, Courtney Jordan-Baechler, William Wagner

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Abstract

Background: Current guidelines recommend multidisciplinary cardiovascular obstetric programs (CVOB) to manage complex pregnant patients with cardiovascular disease. Minimal evaluation of these programs exists, with most of these programs offered at university-based centers.

Methods: A cohort of 113 patients managed by a CVOB team at a non-university health system (2018-2019) were compared to 338 patients seen by cardiology prior to the program (2016-2017). CVOB patients were matched with comparison patients (controls) on modified World Health Organization (mWHO) category classification, yielding a cohort of 102 CVOB and 102 controls.

Results: CVOB patients were more ethnically diverse and cardiovascular risk was higher compared to controls based on mWHO ≥ II-III (57% vs 17%) and. After matching, CVOB patients had more cardiology tests during pregnancy (median of 8 tests vs 5, p < .001) and were more likely to receive telemetry care (32% vs 19%, p = .025). The median number of perinatology visits was significantly higher in the CVOB group (8 vs 2, p < .001). Length of stay was a half day longer for vaginal delivery patients in the CVOB group (median 2.66 vs 2.13, p = .006).

Conclusion: Implementation of a CVOB program resulted in a more diverse patient population than previously referred to cardiology. The CVOB program participants also experienced a higher level of care in terms of increased cardiovascular testing, monitoring, care from specialists, and appropriate use of medications during pregnancy.

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非大学心肺产科课程的覆盖面和有效性。

背景：目前的指南建议采用多学科心血管产科计划（CVOB）来管理患有心血管疾病的复杂孕妇。对这些项目的评估极少，这些项目大多由大学中心提供：将一个非大学医疗系统的 CVOB 团队（2018-2019 年）管理的 113 名患者队列与该计划之前（2016-2017 年）由心脏病科就诊的 338 名患者进行比较。根据修改后的世界卫生组织（mWHO）类别分类，将CVOB患者与对比患者（对照组）进行配对，得出102名CVOB患者和102名对照组患者：根据 mWHO ≥ II-III 级分类，CVOB 患者的种族更加多样化，与对照组相比，CVOB 患者的心血管风险更高（57% 对 17%）。匹配后，CVOB 患者在孕期接受的心脏病学检查次数更多（中位数为 8 次，对照组为 5 次，P = 025）。CVOB组围产期就诊次数的中位数明显高于CVOB组（8次对2次，P = .006）：结论：实施 CVOB 计划后，转诊到心脏科的患者群体比以前更加多样化。结论：CVOB 计划的实施使患者群体比以前转诊到心脏科的患者更加多样化。CVOB 计划的参与者在增加心血管检测、监测、专家护理和孕期合理用药方面也得到了更高水平的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.