A Simplified Echocardiographic Strategy for Heart Failure Diagnosis and Management Within an Integrated Noncommunicable Disease Clinic at District Hospital Level for Sub-Saharan Africa
A Simplified Echocardiographic Strategy for Heart Failure Diagnosis and Management Within an Integrated Noncommunicable Disease Clinic at District Hospital Level for Sub-Saharan Africa
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DOI：
10.1016/j.jchf.2013.03.006
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发表时间：
2013-06-01
影响因子：
13
通讯作者：
Bukhman, Gene
中科院分区：
文献类型：
--
作者：
Kwan, Gene F.;Bukhman, Alice K.;Bukhman, Gene
Objectives本研究旨在描述一个分散的战略心力衰竭的诊断和管理，并报告在农村地区医院的临床流行病学rwandom.Background心力衰竭有助于显着的非传染性疾病负担在撒哈拉以南非洲。专科护理主要由转诊医院的医生提供，限制了病人的就医机会。简化临床策略，可以促进权力下放的优质护理区医院的水平，提高护理delivery.Methods心力衰竭服务建立在综合先进的非传染性疾病诊所在2个农村地区医院在卢旺达。护士在医生的监督下接受培训，使用简化的诊断和治疗算法，包括心脏病专家确认的超声心动图诊断。2006年11月至2011年3月期间治疗的192例心力衰竭患者的数据进行了审查，从电子病历。结果在我们的研究人群中，中位年龄为35岁，70%是女性，63%是自给农民，6%吸烟。入组时，47%的患者具有纽约心脏协会III级或IV级功能状态。儿童年龄
Objectives This study sought to describe a decentralized strategy for heart failure diagnosis and management and report the clinical epidemiology at district hospitals in rural Rwanda.Background Heart failure contributes significantly to noncommunicable disease burden in sub-Saharan Africa. Specialized care is provided primarily at referral hospitals by physicians, limiting patients' access. Simplifying clinical strategies can facilitate decentralization of quality care to the district hospital level and improve care delivery.Methods Heart failure services were established within integrated advanced noncommunicable disease clinics in 2 rural district hospitals in Rwanda. Nurses, supervised by physicians, were trained to use simplified diagnostic and treatment algorithms including echocardiography with diagnoses confirmed by a cardiologist. Data on 192 heart failure patients treated between November 2006 and March 2011 were reviewed from an electronic medical record.Results In our study population, the median age was 35 years, 70% were women, 63% were subsistence farmers, and 6% smoked tobacco. At entry, 47% had New York Heart Association class III or IV functional status. Of children age