心力衰竭病人住入普通病房死亡率加倍
文章来源:未知 文章作者:enread 发布时间:2011-01-18 02:52 字体: [ ]  进入论坛
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Heart failure patients admitted to general wards1 are twice as likely to die as those admitted to cardiology(心脏病学) wards, shows a national audit2 of the treatment of the condition, published online in the journal Heart. Women fared worse than men when it comes to appropriate investigations3 and treatment, the findings suggest, although death rates were similar.

In 2006/7, heart failure accounted for more than a quarter of a million hospital deaths and discharges in England and Wales, equating4 to around 2.5 million bed days a year and at an annual cost to the NHS of £563 million.

The authors draw their conclusions from a survey of the first 10 patients admitted each month with a primary diagnosis5 of heart failure to 86 hospitals across England and Wales between April 2008 and March 2009.

During this period, just over 6,000 patients, with an average age of 78, were admitted with the condition. Almost half of these (43%) were women.

At admission, less than a third (30%) were reported to be breathless at rest and under half (43%) as having swollen6 feet/ankles. These are both diagnostic features of heart failure.

Appropriate investigations were not always carried out, the survey shows, with those admitted to general medical wards less likely to receive these than those admitted to cardiology wards.

Most patients (75%) were given a heart trace monitor test (echocardiogram). But only two thirds of those (65%) admitted to general medical wards were given this test.

This showed that the left ventricular(心室的) ejection fraction (LVEF左心室射血分数), an indicator7 of the pump action of one of the two lower chambers8 of the heart, was 40% or less in most of those admitted.

But LVEF was not recorded in one in four patients. And those with an LVEF of under 40% or in whom LVEF was not recorded were more likely to be women, older, and managed on general medical wards.

Levels of natriuretic peptides(多肽类) , which are a much effective test for heart failure, and a much better barometer9 of likely outcome than LVEF, say the authors, were only measured in 1% of patients, despite National Institute of Health and Clinical Excellence10 recommendations.

Half the patients were admitted to cardiology wards. Compared with those managed on general wards, they tended to be younger and were more likely to be men. Those admitted to general medical wards were twice as likely to die as those admitted to cardiology wards, even after taking account of other risk factors.

While most patients, in whom discharge drug treatment was recorded, were given the appropriate medicines, only half were prescribed beta blockers. Men and younger patients were more likely to be given these drugs.

"Currently, hospital provision of care is suboptimal(次优的) and the outcome of patents poor. The same rules that apply to suspected cancer should pertain11(属于,关于) to a disease with such a malign12 prognosis as heart failure," conclude the authors.

This means ready availability of natriuretic peptide testing, prompt referral to a specialist and appropriately trained staff to manage the condition during and after hospital admission, they say.



点击收听单词发音收听单词发音  

1 wards 90fafe3a7d04ee1c17239fa2d768f8fc     
区( ward的名词复数 ); 病房; 受监护的未成年者; 被人照顾或控制的状态
参考例句:
  • This hospital has 20 medical [surgical] wards. 这所医院有 20 个内科[外科]病房。
  • It was a big constituency divided into three wards. 这是一个大选区,下设三个分区。
2 audit wuGzw     
v.审计;查帐;核对;旁听
参考例句:
  • Each year they audit our accounts and certify them as being true and fair.他们每年对我们进行账务审核,以确保其真实无误。
  • As usual,the yearly audit will take place in December.跟往常一样,年度审计将在十二月份进行。
3 investigations 02de25420938593f7db7bd4052010b32     
(正式的)调查( investigation的名词复数 ); 侦查; 科学研究; 学术研究
参考例句:
  • His investigations were intensive and thorough but revealed nothing. 他进行了深入彻底的调查,但没有发现什么。
  • He often sent them out to make investigations. 他常常派他们出去作调查。
4 equating 07d40297d19f627f0452d3a051f97d50     
v.认为某事物(与另一事物)相等或相仿( equate的现在分词 );相当于;等于;把(一事物) 和(另一事物)等同看待
参考例句:
  • [ Ray ] I definitely started equating crossword puzzles with songwriting. 我已经干脆开始把字谜游戏等同于歌曲写作了。 来自电影对白
  • But they have a hard time equating plural marriage with those evils. 但是他们很难把这种多妻婚姻与上面说的那些坏事联系起来。 来自互联网
5 diagnosis GvPxC     
n.诊断,诊断结果,调查分析,判断
参考例句:
  • His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
  • The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。
6 swollen DrcwL     
adj.肿大的,水涨的;v.使变大,肿胀
参考例句:
  • Her legs had got swollen from standing up all day.因为整天站着,她的双腿已经肿了。
  • A mosquito had bitten her and her arm had swollen up.蚊子叮了她,她的手臂肿起来了。
7 indicator i8NxM     
n.指标;指示物,指示者;指示器
参考例句:
  • Gold prices are often seen as an indicator of inflation.黃金价格常常被看作是通货膨胀的指标。
  • His left-hand indicator is flashing.他左手边的转向灯正在闪亮。
8 chambers c053984cd45eab1984d2c4776373c4fe     
n.房间( chamber的名词复数 );(议会的)议院;卧室;会议厅
参考例句:
  • The body will be removed into one of the cold storage chambers. 尸体将被移到一个冷冻间里。 来自《简明英汉词典》
  • Mr Chambers's readable book concentrates on the middle passage: the time Ransome spent in Russia. Chambers先生的这本值得一看的书重点在中间:Ransome在俄国的那几年。 来自互联网
9 barometer fPLyP     
n.气压表,睛雨表,反应指标
参考例句:
  • The barometer marked a continuing fall in atmospheric pressure.气压表表明气压在继续下降。
  • The arrow on the barometer was pointing to"stormy".气压计上的箭头指向“有暴风雨”。
10 excellence ZnhxM     
n.优秀,杰出,(pl.)优点,美德
参考例句:
  • His art has reached a high degree of excellence.他的艺术已达到炉火纯青的地步。
  • My performance is far below excellence.我的表演离优秀还差得远呢。
11 pertain Y3xzE     
v.(to)附属,从属;关于;有关;适合,相称
参考例句:
  • His remark did not pertain to the question.他的话同这个问题不相干。
  • It does not pertain to you to instruct him.你不适合教训他。
12 malign X8szX     
adj.有害的;恶性的;恶意的;v.诽谤,诬蔑
参考例句:
  • It was easy to see why the cartoonists regularly portrayed him as a malign cherub.难怪漫画家总是把他画成一个邪恶的小天使。
  • She likes to malign innocent persons.她爱诋毁那些清白的人。
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