scholarly journals Practical Care Support During the Early Recovery Period After Acute Coronary Syndrome

2016 ◽  
Vol 37 (7) ◽  
pp. 881-903 ◽  
Author(s):  
Alexandra M. Hajduk ◽  
Jacquelyn E. Hyde ◽  
Molly E. Waring ◽  
Darleen M. Lessard ◽  
David D. McManus ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Recovery Period ◽  
Patient Characteristics ◽  
Informational Support ◽  
Post Discharge ◽  
Early Recovery ◽  
Coronary Syndrome ◽  
Practical Support ◽  
Impaired Health ◽  
Early Recovery Period

Objective: To describe the prevalence and predictors of receipt of practical support among acute coronary syndrome (ACS) survivors during the early post-discharge period. Method: 406 ACS patients were interviewed about receipt of practical (instrumental and informational) support during the week after discharge. Demographic, clinical, functional, and psychosocial predictors of instrumental and informational practical support were examined. Results: 81% of participants reported receiving practical support during the early post-discharge period: 75% reported receipt of instrumental support and 51% reported receipt of informational support. Men were less likely to report receiving certain types of practical support, whereas married participants and those with higher education, impaired health literacy, impaired activities of daily living, and in-hospital complications were more likely to report receiving certain types of practical support. Conclusion: Receipt of practical support is very common among ACS survivors during the early post-discharge period, and type of support received differs according to patient characteristics.

Patterns of development of insomnia in patients with early recovery period of stroke

2019 ◽  
Vol 17 (7) ◽  
pp. 95-99
Author(s):  
O. V. Kurushina ◽  
◽  
E. A. Kurakova ◽  
Keyword(s):  
Recovery Period ◽  
Early Recovery ◽  
Early Recovery Period

Opportunities of ultrasound diagnostics of lung injury in SARS-CoV-2 infection (COVID-19): a clinical case

2020 ◽  
Vol 98 (11) ◽  
pp. 51-56
Author(s):  
G. V. Neklyudova ◽  
А. V. Chernyak ◽  
N. А. Tsareva ◽  
S. N. Аvdeev
Keyword(s):  
Lung Injury ◽  
Clinical Case ◽  
Ultrasound Examination ◽  
Recovery Period ◽  
Early Recovery ◽  
Acute Period ◽  
Ultrasound Diagnostics ◽  
Early Recovery Period

The article describes a clinical case demonstrating the results of the lungs ultrasound examination in the COVID-19 patient during the acute period of the disease and early recovery period.

Abstract 378: Using Lean Methodology to Reduce Variation in Care of Acute Coronary Syndrome Patients

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Guy Fradet ◽  
Carol Laberge ◽  
Andrew Kmetic ◽  
Ronnalea Hamman
Keyword(s):  
Decision Making ◽  
Acute Coronary Syndrome ◽  
Regional Variation ◽  
Coronary Revascularization ◽  
Patient Characteristics ◽  
Care Utilization ◽  
Process Of Care ◽  
Patient Journey ◽  
Coronary Syndrome ◽  
Decision Points

Background: Regional variation in the utilization of health services is a well-documented phenomenon in health care with numerous studies reporting substantial and unexplained variations in coronary revascularization. In the Canadian province of British Columbia (BC), five cardiac centers provide coronary revascularization services. In 2011 Cardiac Services BC (CSBC) undertook a study that identified substantial regional variation in coronary revascularization that could not be explained by patient characteristics or risk factors. Following this initial project, CSBC launched an initiative to help better understand the regional variations and possibly devise and implement strategies to reduce them. To get a better understanding of the different processes of care/utilization, one of the approaches used is the application of Lean methodology to the care of acute coronary syndrome (ACS) patients. Methods: Lean methodology is being applied to the patient journey of ACS patients. At each revascularization center Value Steam Maps process maps (VSM) are being prepared through a series of meetings with support, frontline, administrative and clinical staff (see attached example). For each VSM the goal is to identify key decision points in the process of care for ACS patients and to drill down on (Root Cause Analysis) on the decision making environment and criteria used to determine the utilization of coronary revascularization services. Once VSM have been completed they will be compared across sites for similarities and differences. The differences in decision making will then be assessed to determine their effect on variation in utilization across the centers. Discussion: BC is attempting to reduce unexplained variation in coronary revascularization using the Lean methodology to take a systematic approach to the analysis of the process of ACS care across the province. The next step will be to determine to what extent it is possible to standardize decision making at the key decision points across the HAs. Standardization will be achieved through a mix of best practices, evidence and application of guidelines. While the undertaking is still in the early stages it is expected that it will lead to, at the very least, ACS patients receiving the same care regardless of where they receive their care in BC.

Neurorehabilitation in the Early Recovery Period of Ischemic Stroke. Pharmacology Support

2021 ◽  
Vol 63 (1) ◽  
pp. 22-25
Author(s):  
Denys N. Khramtsov ◽  
Olexandr N. Stoyanov ◽  
Tetiana N. Muratova ◽  
Olexandr R. Pulyk
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Recovery Period ◽  
Rehabilitation Medicine ◽  
Neuroprotective Agents ◽  
Early Recovery ◽  
National Medical ◽  
Cholinergic Agents ◽  
Early Recovery Period ◽  
Medical University

Aim: The aim of the study was to evaluate the clinical outcome in the use of neuroprotective agents in the acute period of ischemic stroke. Material and Methods: The study was performed on the basis of the stroke of the Center for Reconstructive and Rehabilitation Medicine (University Clinic) of the Odessa National Medical University. A retrospective analysis of clinical outcomes of 115 patients with acute stroke was conducted. Results: An average NIHSS score at discharge was 4.1±0.1 points when treated with no refinery, then it reached 3.6±0.1 points when using peptidergic drugs, and 3.4±0.1 when using D-fdf. 3.1±0.1 points. When using D-FDF, the MMSE score was 3.5±0.1 points, whereas when using cholinergic agents, this index did not exceed 26.9±1.5 points, and when using peptidergic agents - 26.8±1.4 points. Conclusion: The use of neuroprotective agents positively affects the effectiveness of neuro-rehabilitation in patients with acute stroke. The best results in three months after the hospitalization were obtained for peptidergic agents and D-fructose-1,6-diphosphate.

Impact of anxiety on the post-discharge outcomes of patients discharged from the hospital after an acute coronary syndrome

2019 ◽  
Vol 278 ◽  
pp. 28-33 ◽  
Author(s):  
Hoang Tran ◽  
Nancy Byatt ◽  
Nathaniel Erskine ◽  
Darleen Lessard ◽  
Randolph S. Devereaux ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Post Discharge ◽  
Coronary Syndrome ◽  
Discharge Outcomes

Abstract 320: Healthcare Resource Utilization Among Patients with Acute Coronary Syndrome Managed with Percutaneous Coronary Intervention and Using Prasugrel or Ticagrelor: A Retrospective Database Analysis

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Cliff Molife ◽  
Mark B Effron ◽  
Mitch DeKoven ◽  
Swapna Karkare ◽  
Feride Frech-Tamas ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Resource Utilization ◽  
Healthcare Resource ◽  
Coronary Intervention ◽  
Healthcare Resource Utilization ◽  
P Value ◽  
Post Discharge ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Objective: To show that prasugrel (pras) was non-inferior to ticagrelor (ticag) in terms of healthcare resource utilization (HCRU) based upon 30- and 90-day all-cause rehospitalization rates among patients (pts) with acute coronary syndrome (ACS) managed with percutaneous coronary intervention (PCI). Methods: This retrospective study used anonymized hospital data from the IMS Patient-Centric Data Warehouse to identify ACS-PCI pts aged ≥18 years with ≥1 in-hospital claim for pras or ticag between 8/1/11-4/30/13. Three cohorts were predefined and analyzed: ACS-PCI (primary cohort), ACS-PCI without prior TIA or stroke (label cohort), and ACS-PCI pts without prior TIA or stroke and if age ≥75 years required evidence of diabetes or prior MI (core cohort). The McNemar’s test was used to evaluate adjusted outcome differences between propensity matched (PM) groups. P-value for non-inferiority (p-NI) test was obtained through a one-sided Z test by comparing log (RR) with log(1.2), a predefined margin. Results: Among 16,098 eligible pts, 13,134 (82%) received pras and 2,964 (18%) received ticag. Compared to ticag pts, pras pts were younger, more likely men, and less likely to have cardiovascular or bleeding risk factors (P<0.05). Of the total population, 1,375 (8.54%) and 2,374 (14.75%) were rehospitalized for any reason within 30 and 90 days post discharge, respectively. After PM adjustment, pras was non-inferior to ticag for 30- and 90-day all-cause rehospitalization rates in all 3 cohorts (p-NI < 0.01). Data are summarized in Table 1. All-cause rehospitalization for the label and core cohorts showed non-inferiority and a significantly lower 90-day rehospitalization rate with pras compared with ticag (Table). Conclusions: All-cause rehospitalizations at 30-and 90-days post discharge in ACS-PCI pts were non-inferior with pras vs. ticag in all 3 cohorts. Pras was associated with significantly lower risk for 90-day all-cause rehospitalizations compared with ticag in the label and core cohorts, which are the majority of pts receiving pras. Although there appears to be inherent bias and unmeasured confounders related to use of pras vs. ticag, these data show reductions in HCRU with pras compared with ticag in the real-world setting at 30- and 90-days post-discharge.

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