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Aftyka J, Staszewski J, Dębiec A, Pogoda-Wesołowska A, Żebrowski J. Can HRV Predict Prolonged Hospitalization and Favorable or Unfavorable Short-Term Outcome in Patients with Acute Ischemic Stroke? Life (Basel) 2023; 13:life13040856. [PMID: 37109385 PMCID: PMC10140812 DOI: 10.3390/life13040856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
The aim of this study was to assess whether the heart rate variability (HRV) could predict a favorable or unfavorable stroke outcome. The endpoint was based on the National Institutes of Health Stroke Scale (NIHSS). The patient's health condition was assessed upon discharge from the hospital. An unfavorable stroke outcome was defined as death or NIHSS ≥ 9, while NIHSS < 9 meant a favorable stroke outcome. The studied group consisted of 59 patients with acute ischemic stroke AIS (mean age of 65.6 ± 13.2; 58% were females). An original and innovative non-linear measure was used to analyze HRV. It was based on symbolic dynamics consisting of comparing the "length of the longest words" in the night recording of HRV. "The length of the longest word" meant the longest sequence of identical adjacent symbols possible for a patient. An unfavorable stroke outcome occurred in 22 patients, whereas the majority of patients (37) had a favorable stroke outcome. The average hospitalization time of patients with clinical progression was 29 ± 14 days, and with favorable outcomes was 10 ± 3 days. Patients with long words (more than 150 adjacent RR intervals having the same symbol) were hospitalized no longer than 14 days and they had no clinical progression. The patients with a favorable stroke outcome were characterized by longer words. Our pilot study may be the beginning of work on the development of a non-linear, symbolic method as a predictor of prolonged hospitalization and increased risk of clinical progression in patients with AIS.
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Affiliation(s)
- Joanna Aftyka
- Faculty of Physics, Warsaw University of Technology, Koszykowa 75, 00-662 Warsaw, Poland
| | - Jacek Staszewski
- Clinic of Neurology, Military Institute of Medicine, Szaserow 128, 04-141 Warsaw, Poland
| | - Aleksander Dębiec
- Clinic of Neurology, Military Institute of Medicine, Szaserow 128, 04-141 Warsaw, Poland
| | | | - Jan Żebrowski
- Faculty of Physics, Warsaw University of Technology, Koszykowa 75, 00-662 Warsaw, Poland
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Pannier J, Nass N, Yaakoub MK, Stelzner FMM, Veit S, Kalomoiri M, Yassine M, Behre G. Monoclonal Antibody Therapy for COVID-19: A Retrospective Observational Study at a Regional Hospital. Infect Dis Rep 2023; 15:125-131. [PMID: 36826353 PMCID: PMC9956015 DOI: 10.3390/idr15010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Monoclonal antibodies represent one option for treatment of COVID-19 early after infection. Although large clinical trials have been successfully conducted, real world data are needed to obtain a realistic assessment of the assumed effect on hospitalization rates. METHODS For this retrospective, observational study, clinical data were collected in 2021 from outpatients (402) as well as hospitalized patients (350) receiving monoclonal antibodies Bamlanivimab, Casirivimab/Imdevimab or Etesevimab/Bamlanivimab. These data were compared with data from a control group of patients not receiving antibodies because admission to the hospital was too late for this therapy. RESULTS Both groups showed a comparable spectrum of risk factors. Due to the late hospitalization of control patients, a higher frequency of severe symptoms, such as fever, dyspnea, syncope and lower viral load, were observed. CRP and leukocytes counts were also higher in the untreated group. Most importantly, hospitalization time was significantly shorter and the number of deaths was also lower in the treated group. CONCLUSIONS Apparently, the application of anti-SARS-CoV-2 antibodies reduced the work load of our hospital as shown by the shorter hospitalization time and lower number of COVID-19-related deaths.
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Stern CS, Plotsker EL, Nelson JA, Matros E, Kalandranis E, Fatterusso D, Mooney C, Chen Y, Velzen J, Mehrara BJ. Optimizing Unilateral Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Quality Improvement Study. J Healthc Qual 2022; 44:354. [PMID: 36036719 PMCID: PMC9633393 DOI: 10.1097/jhq.0000000000000358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Deep inferior epigastric perforator (DIEP) flap surgery commonly involves multiday hospitalization, although data suggest 95% of complications after unilateral DIEP flap breast reconstruction occur within the first 24 hours. The aim of this study was to decrease hospitalization time and optimize care of patients undergoing unilateral DIEP flap breast reconstruction. Our study followed Six Sigma's DMAIC (define, measure, analyze, improve, control) framework. First, we delineated the stakeholders involved in the process and defined workgroups based on temporal relation to the operation. We measured performance according to project SMART (specific, measurable, achievable, relevant, time bound) goals and subsequently conducted an analysis of inefficiencies. We then created new interventions for quality improvement. Control will entail ongoing monitoring to ensure progress is sustained after study completion. Our interventions lasted 6 months and included 70 patients. By actively striving to advance patients through postoperative milestones during their inpatient stay and creating an outpatient nursing roadmap including aspects of inpatient care, we decreased the median length of stay from 67.8 to 44.8 hours ( p < .001). After receiving nursing instruction, 77% of patients agreed that they felt ready to be discharged. Our study suggests that the DMAIC framework can decrease hospitalization time after DIEP surgery and spare resources for additional patients.
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Affiliation(s)
| | | | | | | | | | | | | | - Yigu Chen
- Memorial Sloan-Kettering Cancer Center
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Chen Z, Zhong Q, Chen Y, Chen L, Peng H. The U-shaped association between hospitalization time and fall incidence in inpatients using publicly available data: A cross-sectional study in Japan. Nurs Open 2022; 10:1526-1535. [PMID: 36177862 PMCID: PMC9912438 DOI: 10.1002/nop2.1402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/17/2021] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
AIM To examine the association between the hospitalization time and fall incidence. DESIGN A secondary analysis using the Dryad Digital Repository public database. METHODS Data were extracted from the Fukushima Medical University Hospital cohort study between August 2008 and September 2009. The final analytic sample included 8,598 participants, 156 of who fell. The risk of fall incidents according to hospitalization time was estimated using logistic proportional hazards models, and restricted cubic splines with four knots model were developed. RESULTS The median hospitalization time was 9.00 (4.00, 17.00) days. The incidence of falls was 1.81% (N = 156). A U-shaped association between the hospitalization time and fall incidence, with an inflextion point of 8 days. We found a decreasing fall incidence as the hospitalization time increased from 0 to 8 days (OR 0.72 [0.62 ~ 0.83], p < .001); beyond 8 days, the fall incidence increased as the hospitalization time increased (OR 1.06 [1.04 ~ 1.09]).
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Affiliation(s)
- Zihong Chen
- Department of OncologyWuzhou Red Cross HospitalWuzhouChina
| | - Qiang Zhong
- Department of RadiotherapyWuzhou Red Cross HospitalWuzhouChina
| | - Yonghong Chen
- Department of OncologyWuzhou Red Cross HospitalWuzhouChina
| | - Lihua Chen
- Department of Intensive CareWuzhou Red Cross HospitalWuzhouChina
| | - Huanhuan Peng
- Department of CardiologyWuzhou Red Cross HospitalWuzhouChina
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Gheorghe AG, Călăraşu C, Niţu FM, Demetrian AD, Streba CT. Retrospective Study of Lung Tumor Cases Presenting at a Large Tertiary Hospital in Romania between 2017 and 2020. Curr Health Sci J 2021; 47:54-60. [PMID: 34211748 DOI: 10.12865/CHSJ.47.01.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/20/2021] [Indexed: 11/18/2022]
Abstract
Lung cancer is a major health concern worldwide. A rise in smoking incidence amongst both genders, increased exposure to air pollutants and unhealthy lifestyle choices steadily contribute to this global situation. Our aim was to assess the main characteristics of this type of cancer through a retrospective analysis at a major referral center. We selected valid and complete electronic medical records of patients admitted between 2017 and 2020 at the Emergency County Hospital of Craiova, one of the largest hospitals in Romania and a major referral center for the region of Oltenia. We obtained ethical approval from both the hospital and the University and analyzed anonymized records by ICD-10 diagnostic code, extracting gender and age data, as well as associated conditions, length of stay, as well as the medical departments where the patient was hospitalized. Our results showed an increased incidence amongst men, with the majority of cases between 50 and 70 years of age. Median hospitalization period was of 6 days, with higher values for oncology and the lowest in thoracic surgery. Distant metastases, pleurisy and hemoptysis were the most prevalent comorbidities encountered. In conclusion, our study presents important data on the main characteristics of lung cancer patients in Romania.
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Trintinalha PDEO, Cirino ERI, Marcante RFR, Jabur GR, Buso PL. Surgical treatment in hepatic trauma: factors associated with hospitalization time. Rev Col Bras Cir 2021; 48:e20202784. [PMID: 33787764 PMCID: PMC10683465 DOI: 10.1590/0100-6991e-20202874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/14/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE the aim of this study was to identify associated factors with the increased length of hospital stay for patients undergoing surgical treatment for liver trauma, and predictors of mortality as well as the epidemiology of this trauma. METHODS retrospective study of 191 patients admitted to the Cajuru University Hospital, a reference in the treatment of multiple trauma patients, between 2010 and 2017, with epidemiological, clinicopathological and therapeutic variables analyzed using the STATA version 15.0 program. RESULTS most of the included patients were men with a mean age of 29 years. Firearm injury represents the most common trauma mechanism. The right hepatic lobe was injured in 51.2% of the cases, and hepatorraphy was the most commonly used surgical correction. The length of hospital stay was an average of 11 (0-78) days and the length of stay in the intensive care unit was 5 (0-52) days. Predictors for longer hospital stay were the mechanisms of trauma, hemodynamic instability at admission, number of associated injuries, degree of liver damage and affected lobe, used surgical technique, presence of complications, need for reoperation and other surgical procedures. Mortality rate was 22.7%. CONCLUSIONS the study corroborated the epidemiology reported by the literature. Greater severity of liver trauma and associated injuries characterize patients undergoing surgical treatment, who have increased hospital stay due to the penetrating trauma, hemodynamic instability, hepatic packaging, complications and reoperations.
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Liliac IM, Sacerdotianu MV, Ungureanu BS, Iordache S, Mogoanta L, Saftoiu A, Pirici D. Descriptive Analysis of Patients with Gastric Tumors Referred to the Largest Emergency Hospital in Oltenia Region-Romania, Between 2015-2020. Curr Health Sci J 2021; 47:290-7. [PMID: 34765251 DOI: 10.12865/CHSJ.47.02.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/18/2021] [Indexed: 11/23/2022]
Abstract
Gastric cancer represents the third most frequent cause of death worldwide, with the treatment being impaired also by the fact that patients present in the late stages of disease progression. We have aimed here to evaluate the main clinical and pathological features of all recorded cases of gastric tumor patients presented between January 2015 and December 2020 within the Emergency County Hospital of Craiova. Our retrospective analysis identified a total number of 745 cases, and showed a relative homogenous distribution of the age of the patients / year, with the peak age at presentation of 70-80 years old, and with males having a slightly higher prevalence compared to females. There was no correlation of the number of hospitalization days with the localization of the tumor, but the patients in the age group 60-70 years of age tended to show longer hospitalization times compared to the rest of the age groups. Also, pyloric/ antral tumors tended to present at younger ages compared to other localizations, and interestingly, these patients also represented most of the casuistry. Altogether, the distribution of gastric cancer patients' features did not change significantly in the last 5 years despite treatment advances (especially chemo-and radiotherapy), and the advanced stage of presentation call for a more aggressive detection and increased awareness of the population for this frequent pathology.
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Golpour M, Mousavi T, Alimohammadi M, Mosayebian A, Shiran M, Alizadeh Navaei R, Rafiei A. The effectiveness of Colchicine as an anti-inflammatory drug in the treatment of coronavirus disease 2019: Meta-analysis. Int J Immunopathol Pharmacol 2021; 35:20587384211031763. [PMID: 34250834 PMCID: PMC8274088 DOI: 10.1177/20587384211031763] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/16/2021] [Indexed: 02/05/2023] Open
Abstract
A recently discovered coronavirus, SARS-CoV-2, caused a global respiratory disease pandemic called COVID-19. Many studies have shown the excessive activation of the innate immune response that leads to the adverse outcomes of COVID-19, and anti-inflammatory drugs are very useful in the treatment and management of this infection. The activities of Colchicine, one of the anti-inflammatory drugs, target several pathways related to excessive inflammation of COVID-19. This study aimed to evaluate the efficacy of Colchicine in the treatment of COVID-19 using a meta-analysis approach. Scopus, Pubmed, Google scholars, Web of Science, and Science direct were used to search all the randomized controlled trials, case-control, and cross-sectional studies that have evaluated the efficacy of Colchicine as a treatment for COVID-19 (up to 28 May 2021). The overall effect of Colchicine versus the control group was determined using a random-effects model meta-analysis where we compared changes (i.e. mean differences-Colchicine group vs Control group) between the two conditions in test scores indicative of hospitalization time (day) and mortality rate. The results illustrated Colchicine therapy is associated with a decreased mortality rate in COVID-19 patients and associated with a decrease in hospitalization time (day) in COVID-19 patients. Present preliminary data shows that Colchicine has a beneficial effect on coronavirus disease care in 2019. Therefore, Colchicine can be a good suggestion in the management of COVID-19.
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Affiliation(s)
- Monireh Golpour
- Molecular and Cell Biology Research Center, Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Tahoora Mousavi
- Molecular and Cell Biology Research Center, Hemoglobinopathy Research Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mina Alimohammadi
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Mosayebian
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammadreza Shiran
- Department of Physiology and Pharmacology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Rafiei
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Liu W, Huang L, Zhang C, Liu Z. lncRNA MEG3 is downregulated in ankylosing spondylitis and associated with disease activity, hospitalization time and disease duration. Exp Ther Med 2018; 17:291-297. [PMID: 30651794 PMCID: PMC6307436 DOI: 10.3892/etm.2018.6921] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 09/13/2018] [Indexed: 12/23/2022] Open
Abstract
Long non-coding (lnc)RNA maternally expressed gene 3 (MEG3) has been proved to participate in osteoporosis, which features inverse pathological changes to those associated with spondylosis. The present study aimed to investigate the involvement of lncRNA MEG3 in ankylosing spondylitis. Blood and open sacroiliac joint biopsies were obtained from ankylosing spondylitis patients and healthy controls, and the expression of MEG3 in those tissues was detected by reverse-transcription-quantitative polymerase chain reaction analysis. Disease activity was evaluated according to the Ankylosing Spondylitis Disease Activity Score established by the International Association of Ankylosing Spondylitis. The diagnostic value of MEG3 expression for ankylosing spondylitis was evaluated by receiver operating characteristic curve analysis. The correlation between MEG3 expression and disease activity was assessed using Pearson correlation analysis. Furthermore, according to the median expression level of MEG3, patients were divided into high-level and low-level groups. The hospitalization time and re-hospitalization rate within 2 years after discharge were compared between these two groups and differences in clinicopathological parameters between the two groups were analyzed using the chi-square test. The results indicated that MEG3 was downregulated in ankylosing spondylitis patients compared with that in healthy controls. Furthermore, MEG3 expression levels may be used to effectively distinguish ankylosing spondylitis patients from healthy controls. The serum levels of MEG3 were not associated with the patients' age, sex or alcohol/tobacco consumption, but closely correlated with disease activity and disease duration. In addition, patients with higher expression levels of MEG3 had a shorter hospitalization time and a lower re-hospitalization rate within 2 years after discharge It was concluded that lncRNA MEG3 is downregulated in ankylosing spondylitis patients and is associated with disease activity, time of hospitalization and disease duration.
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Affiliation(s)
- Wei Liu
- Department of Orthopedics, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, P.R. China
| | - Lili Huang
- Department of Infections, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, P.R. China
| | - Cuiying Zhang
- Department of Gynaecology and Obstetrics, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, P.R. China
| | - Zuozhong Liu
- Department of Orthopedics, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, P.R. China
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Eren SH, Korkmaz I, Guven FMK, Tekin YK, Ozdemir L. Serum Paraoxonase, Arylesterase, and Glutathione-S-Transferase Activities and Oxidative Stress Levels in Patients with Mushroom Poisoning. Clinics (Sao Paulo) 2018; 73:e16550. [PMID: 29995097 PMCID: PMC6027757 DOI: 10.6061/clinics/2018/e16-550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 01/30/2018] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Consumption of toxic species of mushrooms may have detrimental effects and increase oxidative stress. Paraoxonase, arylesterase and glutathione-S-transferase are antioxidants that resist oxidative stress. In this study, we analyzed the changes in these enzymes during intoxication due to mushrooms. METHODS The study enrolled 49 adult patients with a diagnosis of mushroom poisoning according to clinical findings and 49 healthy volunteers as the control group. The patients with mild clinical findings were hospitalized due to the possibility that the patient had also eaten the mushrooms and due to clinical findings in the late period, which could be fatal. Paraoxonase, arylesterase, and glutathione-S-transferase concentrations, as well as total antioxidant and oxidant status, were determined in the 49 patients and 49 healthy volunteers by taking blood samples in the emergency department. RESULTS While paraoxonase, arylesterase, and total antioxidant status were significantly decreased in the patient group (p<0.05), glutathione-S-transferase, total oxidant status and the oxidative stress index were significantly higher (p<0.05). There was a positive correlation between the hospitalization time and the oxidative stress index (r=0.752, p<0.001), whereas a negative correlation was found with glutathione-S-transferase (r=-0.420, p=0.003). CONCLUSION We observed a significant decrease in paraoxonase and arylesterase and an increase in glutathione-S-transferase and oxidative stress indexes in patients with mushroom poisoning, indicating that these patients had an oxidative status. In particular, a low total antioxidant status and high oxidative stress index may gain importance in terms of the assessment of hospitalization duration.
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Affiliation(s)
- Sevki Hakan Eren
- Department of Emergency Medicine, Medicine Faculty, Gaziantep University, Gaziantep, Turkey
- *Corresponding author. E-mail:
| | - Ilhan Korkmaz
- Department of Emergency Medicine, Medicine Faculty, Cumhuriyet University, Sivas, Turkey
| | | | - Yusuf Kenan Tekin
- Department of Emergency Medicine, Medicine Faculty, Cumhuriyet University, Sivas, Turkey
| | - Levent Ozdemir
- Department of Public Health, Medicine Faculty, Cumhuriyet University, Sivas, Turkey
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Kim K, Won S, Kim J, Lee E, Kim K, Park S. Meta-analysis of complication as a risk factor for early ambulation after percutaneous coronary intervention. Eur J Cardiovasc Nurs 2012; 12:429-36. [PMID: 23076977 DOI: 10.1177/1474515112462519] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE This study systematically examined previous studies on the effect of early ambulation on vascular complications in subjects who had just undergone a percutaneous coronary intervention (PCI), and analyzed the effects of early ambulation on both hemorrhage and hematoma formation at the puncture site. METHODS Study data were analyzed using the R (version 2.13.1) program. Publication bias was verified via regression analysis, using the logarithm of the odds ratio (OR) and sample size, and a funnel plot using sample size. The risk ratio of the incidence of bleeding and hematoma formation at the puncture site, relative to early ambulation, was confirmed using ORs and the forest plot. RESULTS The PCI recipients' bed rest time had no significant effect on the risk ratio of hematoma formation (OR = 0.89; 95% CI = 0.68-1.17) nor the incidence of bleeding (OR = 1.14; 95% CI = 0.77-1.7) at the puncture site. CONCLUSIONS This retrospective study's findings show that early ambulation following PCI had no effect on the incidence of either hematoma formation nor bleeding at the puncture site; however, differences in demographic factors should be considered carefully, in order to avoid interpreting the results too broadly.
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