Bed Rest Reduction Following Cardiac Catheterizations Using Vascular Closure Devices.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE American Journal of Critical Care Pub Date : 2023-11-01 DOI:10.4037/ajcc2023536

Kristin A Tuozzo, Reena Morris, Nicole Moskowitz, Kathleen McCauley, Anvar Babaev, Michael Attubato

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Abstract

Background: Bed rest duration following deployment of a vascular closure device after transfemoral left-sided cardiac catheterization is not standardized. Despite research supporting reduced bed rest, many hospitals require prolonged bed rest. Delayed ambulation is associated with back pain, urine retention, difficulty eating, and longer stay.

Objective: To study length of stay, safety, and opportunity cost savings of reduced bed rest at a large urban hospital.

Methods: A single-site 12-week study of 1-hour bed rest after transfemoral cardiac catheterizations using vascular closure devices. Results were compared with historical controls treated similarly.

Results: The standard bed rest group included 295 patients (207 male, 88 female; mean [SD] age, 64.4 [8.6] years). The early ambulation group included 260 patients (188 male, 72 female; mean [SD] age, 64 [9.3] years). The groups had no significant difference in age (t634 = 1.18, P = .21) or sex (χ12=0.2, P = .64). Three patients in the standard bed rest group and 1 in the early ambulation group had hematomas (P = .36). The stay for diagnostic cardiac catheterizations was longer in the standard bed rest group (mean [SD], 220.7 [55.2] minutes) than in the early ambulation group (mean [SD], 182.1 [78.5] minutes; t196 = 4.06; P < .001). Stay for percutaneous coronary interventions was longer in the standard bed rest group (mean [SD], 400.2 [50.8] minutes) than in the early ambulation group (mean [SD], 381.6 [54.7] minutes; t262 = 2.86; P = .005).

Conclusion: Reduced bed rest was safe, shortened stays, and improved efficiency by creating opportunity cost savings.

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使用血管闭合装置进行心脏导管置入术后减少卧床休息。

背景：经股左心导管插入术后部署血管闭合装置后的卧床休息时间没有标准化。尽管研究支持减少卧床休息，但许多医院需要长时间卧床休息。延迟行走与背痛、尿潴留、进食困难和住院时间延长有关。目的：研究大型城市医院减少卧床休息的住院时间、安全性和机会成本节约。方法：一项为期12周的单点研究，使用血管闭合装置进行经股心导管置入术后1小时的卧床休息。将结果与类似治疗的历史对照组进行比较。结果：标准卧床休息组包括295名患者（207名男性，88名女性；平均[SD]年龄64.4[8.6]岁）。早期行走组包括260名患者（188名男性，72名女性；平均[SD]年龄，64[9.3]岁）。两组患者的年龄（t634=1.18，P=.21）或性别（χ12=0.2，P=.64）无显著差异。标准卧床休息组有3名患者出现血肿（P=.36），早期活动组有1名患者出现出血（P=0.36）。标准卧床组的诊断性心导管留置时间（平均[SD]，220.7[55.2]分钟）长于早期活动组（平均[SS]，182.1[78.5]分钟）分钟t196＝4.06；P<.001）。标准卧床组经皮冠状动脉介入治疗的住院时间（平均[SD]400.2[508]分钟）比早期活动组（平均[SS]381.6[54.7]分钟；t262=2.86；P=0.005）更长。结论：减少卧床休息是安全的，缩短了住院时间，并通过节省机会成本提高了效率。

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

American Journal of Critical Care 医学-护理

CiteScore

4.30

自引率

3.70%

发文量

103

审稿时长

6-12 weeks

期刊介绍： The editors of the American Journal of Critical Care (AJCC) invite authors to submit original manuscripts describing investigations, advances, or observations from all specialties related to the care of critically and acutely ill patients. Papers promoting collaborative practice and research are encouraged. Manuscripts will be considered on the understanding that they have not been published elsewhere and have been submitted solely to AJCC.

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