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Li F, Luo R, Wang XT, Jia JF, Yu XY. Current situation of acute ST-segment elevation myocardial infarction in a county hospital chest pain center during an epidemic of novel coronavirus pneumonia. Open Med (Wars) 2023; 18:20220621. [PMID: 36694625 PMCID: PMC9830634 DOI: 10.1515/med-2022-0621] [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: 09/28/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 01/11/2023] Open
Abstract
Our object was to examine how the pre- and post-pandemic COVID-19 impacted the care of acute ST-segment elevation myocardial infarction (STEMI) patients in county hospitals. Using January 20, 2020, as the time point for the control of a unique coronavirus pneumonia epidemic in Jieshou, 272 acute STEMI patients were separated into pre-epidemic (group A, n = 130) and epidemic (group B, n = 142). There were no significant differences between the two groups in terms of mode of arrival, symptom onset-to-first medical contact time, door-to-needle time, door-to-balloon time, maximum hypersensitive cardiac troponin I levels, and in-hospital adverse events (P > 0.05). Emergency percutaneous coronary intervention (PCI) was much less common in group B (57.7%) compared to group A (72.3%) (P = 0.012), and the proportion of reperfusion treatment with thrombolysis was 30.3% in group B compared to 13.1% in group A (P < 0.001). Logistic regression analysis showed that age ≥76 years, admission NT-proBNP levels ≥3,018 pg/ml, and combined cardiogenic shock were independent risk factors for death. Compared with thrombolytic therapy, emergency PCI treatment further reduced the risk of death in STEMI. In conclusion, the county hospitals treated more acute STEMI with thrombolysis during the COVID-19 outbreak.
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Affiliation(s)
- Feng Li
- Department of Cardiology, Jieshou People’s Hospital, 339 Renmin Road, Jieshou, Fuyang, Anhui, 236500, China
| | - Rong Luo
- Department of Cardiology, Jieshou People’s Hospital, Jieshou, Fuyang, Anhui, 236500, China
| | - Xiao-Ting Wang
- Department of Cardiology, Jieshou People’s Hospital, Jieshou, Fuyang, Anhui, 236500, China
| | - Jun-Feng Jia
- Department of Cardiology, Jieshou People’s Hospital, Jieshou, Fuyang, Anhui, 236500, China
| | - Xue-Ying Yu
- Department of Cardiology, Jieshou People’s Hospital, Jieshou, Fuyang, Anhui, 236500, China
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Yu J, Leung MY, Ma G, Xia J. Older Adults' Access to and Satisfaction With Primary Hospitals Based on Spatial and Non-spatial Analyses. Front Public Health 2022; 10:845648. [PMID: 35570922 PMCID: PMC9096154 DOI: 10.3389/fpubh.2022.845648] [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: 12/30/2021] [Accepted: 02/14/2022] [Indexed: 11/14/2022] Open
Abstract
In order to improve the health and quality of life of older adults, the Chinese government is dedicated to establishing an equilibrium level of primary healthcare services for all communities. However, little attention has been paid to measuring the accessibility of primary hospitals to older adults, nor to understanding the seniors' satisfaction with and needs for primary healthcare services. Therefore, this study sought to investigate the spatial accessibility of primary hospitals to older adults, and also to examine the impact of walking distances on the seniors' satisfaction with their healthcare services. A two-step floating catchment area method was applied to measure the spatial accessibility of primary hospitals to older adults at the level of subdistricts. In order to investigate the actual opinions of older adults and verify the results of spatial analysis, a large-scale questionnaire survey was also conducted. The analyses found that (1) primary hospitals were not equally distributed; (2) most older adults did not have access to primary hospitals within a threshold walking distance of 1,000 m, but they usually could reach a hospital in their subdistrict within a threshold distance of 2,000 m; (3) older adults' satisfaction levels with primary hospitals were significantly different among subdistricts; (4) long walking distances negatively influenced older adults' satisfaction with primary hospitals; (5) the satisfaction of older adults was highest with a threshold distance of 500 m; and (6) a piecewise regression model indicated that older adults' satisfaction with primary hospitals would decrease with an increase in walking distance to the hospital. When the walking distances exceeded 1,000 m, the slope of the linear regression model increased significantly compared with the slope for walking distances less than 1,000 m. By adopting multiple research methods and capturing older adults' behaviors and satisfaction, our results provide (1) data on the importance of accessibility of primary hospitals to older adults, and (2) insights for future planning to achieve equity in primary healthcare and enhance the spatial distribution of primary hospitals.
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Affiliation(s)
- Jingyu Yu
- School of Civil Engineering, Hefei University of Technology, Hefei, China
| | - Mei-Yung Leung
- Department of Architectural and Civil Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Guixia Ma
- School of Foreign Studies, Hefei University of Technology, Hefei, China
| | - Jingcheng Xia
- School of Foreign Studies, Hefei University of Technology, Hefei, China
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Denu ZA, Yassin MO, Azale T, Biks GA, Gelaye KA. Insufficient Supply, Diagnostic Services, and Lack of Trained Personnel in Primary Hospitals in North-West Ethiopia Worsened Trauma Care: A Mixed-Method Study. Disaster Med Public Health Prep 2022; 17:e135. [PMID: 35331362 DOI: 10.1017/dmp.2022.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Although there has been a massive expansion of hospitals in Ethiopia in the last 2 decades, most are primary-level hospitals. Assessing the capability of the hospitals in managing trauma victims is essential to strengthening the hospitals. METHODS We employed a mixed-method approach using quantitative descriptive design triangulated with qualitative research. We audited 10 hospitals using WHO essential trauma care checklist. We interviewed 37 health care professionals, 9 hospital managers, and 12 decision-makers using a semi-structured interview guide. We used the COREQ checklist to report the qualitative finding. RESULTS The physical structures of the hospitals were good in all cases. Airway, breathing and circulation management were partially available, with a score ranging from 0 - 3. The extent of injury, lack of radiology service, and scarcity of drugs and supplies were common causes for the referral of trauma victims to Gondar University hospital. CONCLUSION AND RECOMMENDATION Unavailability of drugs and supplies, lack of diagnostic services, inability to recruit specialist professionals, lack of training, and inconvenient working and living environment were stated as the main barriers to providing trauma care. In the study area, the gaps in trauma care in the primary hospitals can be improved by further commitment of the hospitals, the district, zonal administrators, and the regional health bureau.
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Xu B, Zhang J, Hou J, Ma M, Gong Z, Tang S. Nurses' Attitudes and Knowledge of Peripherally Inserted Central Catheter Maintenance in Primary Hospitals in China: A Cross-Sectional Survey. Risk Manag Healthc Policy 2020; 13:903-913. [PMID: 32801965 PMCID: PMC7395679 DOI: 10.2147/rmhp.s250741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/02/2020] [Indexed: 01/25/2023] Open
Abstract
Background and Aim The promotion of peripherally inserted central catheter (PICC) maintenance in primary hospitals can benefit discharged patients with PICCs living in remote areas a lot. Yet, no primary hospitals had introduced PICC maintenance technology in Hunan province, China. The present study aimed to evaluate nurses’ attitudes and knowledge of PICC maintenance in primary hospitals in Hunan province, China. Materials and Methods From November 2018 to January 2019, a total of 560 nurses from 28 community hospitals and 28 township hospitals in 14 cities across Hunan were recruited in the present study. All nurses were registered nurses engaged in clinical work related to intravenous infusion, and their attitudes and knowledge of PICC maintenance were measured by a self-designed questionnaire that was based on literature review and expert consultation. Results The response rate was 93.6% (560 of 598). Almost all participants could realize the importance and necessity of PICC maintenance. More than 90% of the participants expressed interest in PICC maintenance and showed strong demands for relevant training. However, the nurses’ correct response rate of most knowledge items was at a low level (7.14–57.68%), with only three items exhibiting the correct response rate of 90% or higher. The factors influencing the nurses’ PICC maintenance knowledge included their nursing experience, professional title, work setting, and department. Conclusion Although nurses in primary hospitals had a positive attitude toward PICC maintenance, their knowledge level was unsatisfactory, which might be a barrier to the promotion of PICC maintenance technology in primary hospitals in Hunan province, China. Multiple parties should get involved and take measures to improve the nurses’ PICC maintenance knowledge, including the government, nursing associations, large-scale hospitals, and primary hospitals themselves. Besides, new training models and dynamic assessment methods should be explored to improve training effectiveness in the future.
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Affiliation(s)
- Binbin Xu
- Teaching and Research Office of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,Xiangya Nursing School, Central South University, Changsha, Hunan, People's Republic of China
| | - Jinghui Zhang
- Teaching and Research Office of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Jianmei Hou
- Xiangya Nursing School, Central South University, Changsha, Hunan, People's Republic of China
| | - Mengdan Ma
- Xiangya Nursing School, Central South University, Changsha, Hunan, People's Republic of China
| | - Zhihong Gong
- Xiangya Nursing School, Central South University, Changsha, Hunan, People's Republic of China
| | - Siyuan Tang
- Xiangya Nursing School, Central South University, Changsha, Hunan, People's Republic of China
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Kularatne SAM, Shahmy S, Rathnayake SS, Dawson AH. Clinico-epidemiology of arthropod stings and bites in primary hospitals of North Western province of Sri Lanka. Clin Toxicol (Phila) 2018; 56:880-885. [PMID: 29508631 DOI: 10.1080/15563650.2018.1447120] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Arthropod stinging and bites are common environmental hazards in Sri Lanka. However, their medical importance has not been fully evaluated yet. This study aims to study the burden, epidemiology, and outcome of stings and bites in primary hospitals in the Kurunegala district in North Western Province (NWP) of Sri Lanka. METHODOLOGY The study was conducted one year from 25th May 2013 to 25th May 2014. Details of all stings and bites admissions and their outcomes were retrospectively extracted from hospital records in all 44 primary hospitals in the district. RESULTS There were 623 stings and bites with population incidence of 38/100,000 (95% CI 27-52). There were no deaths. Median age was 38 years (IQR: 19-53 years), and 351 (56%) were males. Most of stings and bites (75%) occurred in the daytime. Median time to hospital arrival was 55 minutes (IQR: 30 min to 2 h). The offending arthropods had been identified in 557 (89%) cases, of them, 357 (57%) were Hymenoptera (hornet and bees), 99 centipedes, 61 spiders and 40 scorpions. Local pain occurred in 346 (56%) cases - centipede 69 (70%), Scorpion 24 (60%), spider 36 (59%), Hymenoptera 187 (52%) and unidentified 30 (45%). Hymenoptera stings and spider bites occurred between 06 am to 12 noon, and scorpion stings and centipede bites mostly occurred between 06 pm to 12 midnight. Mild, moderate to severe anaphylaxis reactions occurred in 173 (28%) patients including 110 Hymenoptera stings - mild 39, moderate 62 and severe 9. From primary hospitals, 53(9%) cases had been transferred to tertiary care units for further management. Of them, 41 cases were Hymenoptera stings and 24 (58%) of them had mild, moderate to severe anaphylaxis. In the entire group, 27% severe cases received adrenaline. CONCLUSIONS The primary hospitals in NW province of Sri Lanka manage large numbers of arthropod stings and bites. These include Hymenoptera (hornet and bee), centipedes, spiders, and scorpions. Pain, swellings and anaphylactic reactions were the most common adverse effects.
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Affiliation(s)
| | - Seyed Shahmy
- b South Asian Clinical Toxicology Research Collaboration , University of Peradeniya , Peradeniya , Sri Lanka
| | - Shantha S Rathnayake
- b South Asian Clinical Toxicology Research Collaboration , University of Peradeniya , Peradeniya , Sri Lanka
| | - Andrew H Dawson
- b South Asian Clinical Toxicology Research Collaboration , University of Peradeniya , Peradeniya , Sri Lanka.,c Central Clinical School , University of Sydney , Sydney , Australia
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Liu X, Tong X, Jin L, Ha M, Cao F, Xu F, Chi Y, Zhang D, Xu L. Prospective study on the overuse of blood test-guided antibiotics on patients with acute diarrhea in primary hospitals of China. Patient Prefer Adherence 2017; 11:537-545. [PMID: 28352160 PMCID: PMC5359135 DOI: 10.2147/ppa.s123294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Overuse with antibiotics in the treatment of infectious diseases has become a central focus of public health over the years. The aim of this study was to provide an up-to-date evaluation of the blood test-guided antibiotic use on patients with acute diarrhea in primary hospitals of China. MATERIALS AND METHODS A cross-sectional survey was conducted on 330 patients with acute diarrhea in Shanghai, People's Republic of China, from March 2013 to February 2016. These patients were treated with or without antibiotics based on the results of their blood tests, including examinations of C-reactive protein (CRP), white blood cells (WBC), and the percentage of neutrophils (Neu%). The infection types, which included bacterial, viral, and combination diarrhea, were determined by microbiological culture methods. Antibiotics used in non-bacterial diarrhea patients were considered misused and overused. RESULTS There were significant overall differences in the clinical characteristics and blood tests between patients with diarrhea with a bacterial infection and patients with other types of infections. The patients were divided into four grading groups (0-3) according to the number of the positive results from three blood testes (CRP, WBC, and Neu%). The misuse rates of antibiotics in each group (0-3) were 81.3%, 71.1%, 72.4%, and 64.9%, respectively. CONCLUSION In this prospective study, the current diagnostic criteria (CRP, WBC, and Neu%) based on blood tests are not reliable in diagnosing bacterial diarrhea or guiding antibiotics use. To limit antibiotic overuse, a rapid and accurate differentiation of bacterial diarrhea from other types of diarrhea is pivotal.
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Affiliation(s)
| | - Xueke Tong
- Department of Infectious Diseases, Shanghai Gongli Hospital, The Second Military Medical University
| | - Liyin Jin
- Department of Laboratory, Jinyang Community Health Service Center, Pudong New District
| | - Minghao Ha
- Department of Infectious Diseases and Hepatology, The Affiliated Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine
| | - Feng Cao
- Department of Preventive Care, Shanghai Gongli Hospital, The Second Military Medical University, Shanghai, People’s Republic of China
| | | | | | - Denghai Zhang
- Department of Laboratory
- Correspondence: Limin Xu; Denghai Zhang, Department of Clinical Laboratory, Shanghai Gongli Hospital, The Second Military Medical University, 219 Miaopu Rd, Pudong New Area, Shanghai 200135, People’s Republic of China, Tel +86 21 5885 8730 ext 5236; 5177, Fax +86 21 5821 9029, Email ;
| | - Limin Xu
- Department of Laboratory
- Correspondence: Limin Xu; Denghai Zhang, Department of Clinical Laboratory, Shanghai Gongli Hospital, The Second Military Medical University, 219 Miaopu Rd, Pudong New Area, Shanghai 200135, People’s Republic of China, Tel +86 21 5885 8730 ext 5236; 5177, Fax +86 21 5821 9029, Email ;
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