Journal of Vascular Nursing最新文献

Background

Disseminated Intravascular Coagulation (DIC) has been assessed by the International Society of Thrombosis and Hemostasis (ISTH) 2001 and the ISTH 2018-modified version. More investigations are needed to assess usability and visibility of those DIC scoring systems in the intensive care units (ICU).

Aims

This study investigated the predictive performance of the ISTH–Overt DIC versions of 28–day mortality in ICUs compared to SOFA as a gold standard assessment tool of sepsis.

Methods

A retrospective design (2015–2017) included 220 adult patients enrolled from medical and surgical ICUs in two major hospitals in Jordan. We calculated ISTH–Overt DIC scores and SOFA score on time of DIC diagnosis. Overt DIC was categorized based on a score of ≥ five for ISTH DIC 2001; and ≥ 4 for ISTH DIC 2018. Provided, a score > 12 was categorized as Multiple–Organ– Dysfunction–Syndrome (MODS) for Sequential Organ Failure Assessment (SOFA) score. Then, 28–day mortality follow-up was performed.

Results

More than half of sample died before 28–days of follow–up. The analysis of Receiver Operating Characteristic (ROC) showed that higher scores of ISTH DIC 2001(≥ 5), ISTH DIC 2018 (≥ 4), and SOFA score (>12) were highly associated with 28–day mortality. The ISTH DIC 2001 and SOFA score were superior on the modified ISTH 2018 in predicting 28–day mortality, with an Area Under the Curve (AUC) of (0.724 vs. 0.822 vs. 0.507, respectively). Yet, the accuracy of the SOFA score was better than the ISTH DIC 2001. Conclusion: This study suggests that ISTH DIC 2001 score is helpful when applied on medical and surgical ICU Jordanian populations. It showed better results compared to the Modified ISTH DIC 2018 in mortality prediction, regardless of the underlying diseases.

Antineoplastic chemotherapy patients are susceptible to vascular trauma. The identification of this problem is possible through accurate clinical indicators. However, there are few diagnostic accuracy studies of vascular trauma in these patients. Thus, the objective was to analyze the accuracy of clinical indicators of vascular trauma in antineoplastic chemotherapy patients. A diagnostic accuracy study was carried out with a sample of 200 patients undergoing antineoplastic chemotherapy, in an oncology reference clinic, during 2018. A data collection form was created with sociodemographic and clinical data and indicators of vascular trauma. The sensitivity and specificity of the clinical indicators were assessed using a latent class analysis of random effects. The clinical indicators of decreased vascular elasticity (0.8384), pain (0.9573), and signs of infection at the catheter insertion site (0.9999) were specific for identifying vascular trauma in antineoplastic chemotherapy patients. The prevalence of vascular trauma in these patients was 11.17%. A set of three clinical indicators was considered accurate and statistically significant for confirming vascular trauma. This study has provided accurate clinical indicators of vascular trauma in antineoplastic chemotherapy patients. These results can contribute to establishing interventions, thereby reducing costs and maximizing health outcomes in this population.

Objective

Venous thromboembolism is one of the most common cardiovascular disorders in the any intensive care units (ICUs), which annually leads to death and imposes great costs on patients and society worldwide. The present study was conducted with the aim of determining the prevalence and factors related to venous thromboembolism in the ICUs as a systematic review and meta-analysis.

Methods

The current study was conducted in international databases, on all descriptive and analytical studies and clinical and semi-experimental trial studies, without time limit until November 2, 2021. The present study was designed and implemented based on PRISMA guideline. The quality of the studies was checked using STROBE checklist and meta-analysis was performed using CMA software.

Results

Among the 3204 articles found, after the evaluations, 189 articles entered the full text review phase, and as a result, 38 articles were included in the study. The reported prevalence of thromboembolism was 1-45%. The prevalence of venous thromboembolism was 12% in overall. The chance of venous thromboembolism was higher in ICUs patients >57 years old and ICUs patients with a history of venous thromboembolism.

Conclusion

The results of this study showed that venous thromboembolism has a higher prevalence in ICUs patients in comparison to non-ICUs patients. It is recommended to nurses and healthcare staffs to provide accurate decision and care for prevention of venous thromboembolism and paying attention to the patient's warning signs, timely administration of anticoagulants, and monitor coagulation factors.

Abstract

The majority of patients receiving chemotherapy undergo PICC catheterization. However, PICCs are significantly associated with catheter related complications, including deep vein thrombosis, blood infection, fibrin sheath, catheter prolapse, catheter displacement and blockage. Of all the risks, PICC-related VT was the most prevailing clinic symptom and resulted in a high risk of death.

Aim

The study aimed to investigate the preventive efficacy and safety of aspirin for patients with malignant tumors receiving venous thrombosis (VT) related with peripherally inserted central catheters (PICC) treatment.

Patients and Methods

A randomized controlled trial was conducted. Participants with malignant tumors receiving chemotherapy who accepted PICC insertion operation were randomly allocated to the aspirin treatment group (n = 235) or the control group (n = 246). The patients in the aspirin group were administrated aspirin (100mg) for 30 days, whereas the patients in control group were administrated a placebo drug. The incidence of PICC-related VT in both groups and the aspirin related adverse effects were evaluated.

Results

The incidence of PICC-related VT was 0.4% in the aspirin group, compared with 3.3% in the control group (P = 0.038). In addition, aspirin related bleeding was not observed.

Conclusion

PICC-related VT could be effectively prevented by aspirin in patients with malignant tumors.

Background

Government responses and restrictions due to the COVID-19 pandemic (e.g., limits to non-urgent health care services, including non-urgent outpatient appointments) led to the suspension of center-based (in-person) cardiac rehabilitation (CR), with many programs switching to virtual delivery. This study aimed to understand the characteristics and correlates of disease-related knowledge and exercise self-efficacy in a group of patients attending a virtual CR program during the first COVID-19 lockdown in Peru.

Methods

In this prospective observational study, 240 patients receiving virtual CR care (exercise instructions and patient education) between August/2020 and December/2021 completed questionnaires pre- and post-CR assessing disease-related knowledge (CADE-Q SV questionnaire) and self-efficacy (SE; Bandura's Exercise SE scale). Paired t tests were used to investigate changes pre/post-CR and Pearson correlation coefficients were used to determine the association between knowledge/SE and patients’ characteristics.

Results

Participants were mainly comprised of men, with a cardiac diagnosis of stable coronary artery disease, who underwent percutaneous coronary intervention or had a known diagnosis of hypertension and with at least one cardiovascular risk factor (95.8%). Mean total knowledge scores improved significantly at post-CR (12.9 ± 2.4 to 15.6 ± 2.0/20; p<0.001), as well as in 4/5 knowledge areas (cardiovascular risk factors, exercise, nutrition, and psychosocial risk; p<0.001). Mean SE scores improved significantly at post-CR (1.9 ± 0.9 to 3.0 ± 0.9/5; p = 0.01). Post-CR knowledge and SE were significantly correlated with cardiac diagnosis and surgical procedures (r = 0.17, p = 0.02 and r = 0.27, p = 0.02, respectively).

Conclusions

The virtual CR program improved disease-related knowledge and SE of cardiac patients during the first months of the COVID-19 pandemic. Post-CR outcomes were correlated with cardiac diagnosis and surgical procedures and more research with other characteristics is warrantied.

Background

Considering the morbidity, mortality, and financial burden of cardiovascular diseases(CVDs), investigating measures to prevent these disorders is highly prioritized. In this regard, improving the patients' knowledge level is essential. This study aimed to determine influencing factors on knowledge level regarding cardiovascular risk factors.

Methods

This research is a descriptive-analytic study in which 351 hospitalized patients were selected as participants. The study was conducted in the cardiovascular services of a state hospital in Northern Nicosia, Cyprus, between 2019 and 2020. Data were gathered using a questionnaire through face-to-face interviews. The questionnaire was composed of two sections: the Cardiovascular Diseases Risk Factors Knowledge Level (CARRIF-KL) and a researchers-designed tool for demographic and influencing factors. Data were analyzed by IBM SPSS Statistics 25. The Mann-Whitney U, Pearson chi-square, Spearman correlation, Kruskal Wallis, and Linear Regression were used for data analysis.

Results

The highest proportion of participants were aged 55–69 years (N = 154; 44%), male (N = 245; 70%), and married (N = 320; 91%). The most common reported chronic conditions were hypertension (N = 66; 44%) followed by obesity (N = 48; 32%). Also, 63.53% (N = 222) of the participants reported smoking, and 71% (N = 249) reported alcohol consumption. The mean Body Mass Index (BMI) of the participants was calculated as 30.37 (5.92) for women and 31.30 (4.75) for men. There was a statistically significant difference in the quantity of CARRIF-KL between age groups, educational level, job, personality type, housing, number of daily meals, and being on a diet. The Linear Regression confirmed two predictors for CARRIF-KL, including education level and personality trait.

Conclusion

Despite the common belief that people of the Mediterranean region practice a healthy lifestyle, results showed that obesity, smoking, sedentary life, and alcohol consumption are significant problems in Northern Cyprus. Considering the influencing factors and the predictors of the CARRIF-KL, we may recommend focusing on education at younger ages, increasing awareness about the importance of CVD risk factors, and keeping a normal body weight by reducing the number of daily meals and diet.

Background

Hypertension is a common chronic disease that causes serious complications. Therefore, its management is critical. Many factors affect the management of hypertension, such as care satisfaction and antihypertensive medication adherence.

Aim

This study investigated the relationship between hypertensive patients' satisfaction with hypertension care and their antihypertensive medication adherence.

Materials and Methods

This descriptive-correlational study was conducted between October 2016 and February 2017. A total of 407 patients meeting the inclusion criteria were enrolled in the study. The data were collected using the descriptive questionnaire, the Patient Assessment of Chronic Illness Care (PACIC) to determine care satisfaction, and the Medication Adherence Self-Efficacy Scale-Short Form (MASES-SF). Blood pressure, body height, and weight were also measured.

Results

Patients had a low mean PACIC score and a good mean score on the MASES-SF. Their PACIC scores differed by age, gender, number of daily antihypertensive medications, time since last examination due to hypertension, getting information about hypertension, and blood pressure control status (p < 0.05). Their MASES-SF scores differed by perceived economic status, time since hypertension diagnosis, duration of antihypertensive medication use, time since last examination due to hypertension, and blood pressure control status. In addition, there was a weak positive and significant correlation between PACIC and MASES-SF scores (p < 0.001).

Conclusions

Patients have low satisfaction with hypertension care and good antihypertensive medication adherence. As satisfaction with hypertension care increases, adherence to antihypertensive medication increases.