Dilemmas in end-stage heart failure.
Dilemmas in end-stage heart failure.
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DOI：
10.11909/j.issn.1671-5411.2015.01.007
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Scarabelli TM
中科院分区：
文献类型：
--
作者：
Chen-Scarabelli C;Saravolatz L;Hirsh B;Agrawal P;Scarabelli TM
心力衰竭(HF)是一种由心脏结构或功能障碍引起的复杂的临床综合征，是一个主要的全球健康问题，仅在美国就有超过580万人患病率，全球超过2300万人。作为65岁或65岁以上患者住院的主要原因，心力衰竭是医疗资源的主要消费者，给医疗系统造成了巨大的压力。本文讨论了心力衰竭的流行病学、经济影响和终末期心力衰竭护理中的多方面困境。在美国国家医学图书馆网站(www.pubmed.gov)上进行了搜索，关键词包括终末期心力衰竭、姑息治疗、伦理困境。尽管心衰的预后很差(比许多癌症的预后都差)，但许多心衰患者、照顾者和临床医生并不知道预后很差。此外，心力衰竭不可预测的临床轨迹使临终关怀的规划复杂化，如姑息治疗和临终关怀，导致这些资源未得到充分利用。总而言之，终末期心力衰竭的伦理困境很多，不仅牵涉到患者，也牵涉到照顾者、医疗保健团队和社会。
Heart failure (HF), a complex clinical syndrome due to structural or functional disorder of the heart, is a major global health issue, with a prevalence of over 5.8 million in the USA alone, and over 23 million worldwide. As a leading cause of hospitalizations among patients aged 65 years or older, HF is a major consumer of healthcare resources, creating a substantial strain on the healthcare system. This paper discusses the epidemiology of HF, financial impact, and multifaceted predicaments in end-stage HF care. A search was conducted on the U.S. National Library of Medicine website (www.pubmed.gov) using keywords such as end-stage heart failure, palliative care, ethical dilemmas. Despite the poor prognosis of HF (worse than that for many cancers), many HF patients, caregivers, and clinicians are unaware of the poor prognosis. In addition, the unpredictable clinical trajectory of HF complicates the planning of end-of-life care, such as palliative care and hospice, leading to underutilization of such resources. In conclusion, ethical dilemmas in end-stage HF are numerous, embroiling not only the patient, but also the caregiver, healthcare team, and society.
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影响因子：
49.6
作者：
Bui, Anh L.;Horwich, Tamara B.;Fonarow, Gregg C.
通讯作者：
Fonarow, Gregg C.
影响因子：
120.7
作者：
Chen, Jersey;Normand, Sharon-Lise T.;Krumholz, Harlan M.
通讯作者：
Krumholz, Harlan M.
DOI：
10.1161/hhf.0b013e318291329a
发表时间：
2013-05
期刊：
Circulation. Heart failure
影响因子：
--
作者：
Heidenreich PA;Albert NM;Allen LA;Bluemke DA;Butler J;Fonarow GC;Ikonomidis JS;Khavjou O;Konstam MA;Maddox TM;Nichol G;Pham M;Piña IL;Trogdon JG;American Heart Association Advocacy Coordinating Committee;Council on Arteriosclerosis, Thrombosis and Vascular Biology;Council on Cardiovascular Radiology and Intervention;Council on Clinical Cardiology;Council on Epidemiology and Prevention;Stroke Council
通讯作者：
Stroke Council
影响因子：
5.7
作者：
Fried, Terri R.;O'Leary, John R.
通讯作者：
O'Leary, John R.
影响因子：
4.8
作者：
Costanzo, Maria R.;Mills, Roger M.;Wynne, Janet
通讯作者：
Wynne, Janet