Blood Pressure and Risks of Cardiac Catheterization

描述（由申请人提供）：本研究的长期目标是增加指导护理方案制定的知识，并识别高风险介入心脏病患者。这项前瞻性、描述性、相关性研究的目的是确定变量的相对贡献：年龄、性别、体重指数、高血压病史、糖尿病、外周血管疾病、抗凝、手术类型、卧床时间（TIB）和平均收缩压预测经皮诊断性心导管插入术（CC）和冠状动脉介入治疗（PCI）后血管穿刺部位并发症。本研究中的并发症为：血肿、出血、动静脉瘘、假性动脉瘤、腹膜后出血和血管闭塞。本研究的意义在于：（1）接受CC和PCI的人群数量庞大。1999年，美国有超过2，432，000名患者接受了这些手术，2010年健康人群的目标是在症状出现后一小时内接受动脉开放治疗的患者增加20%。保守估计，在近300万例手术中，3%的血管并发症意味着每年有近90，000例患者受到影响。(2)照顾这些病人是护士的责任。关于TIB和鞘管取出期间血压控制的决定由护士做出。CC和PCI后护理的知识指导护理方案尚未建立在证据基础上。

DESCRIPTION (provided by applicant): The long term goal of this research is to add to knowledge guiding protocol development for nursing care and identification of high risk interventional cardiology patients. The purpose of this prospective, descriptive, correlational study is to determine the relative contributions of the variables: age, gender, body mass index, history of hypertension, diabetes mellitus, peripheral vascular disease, anticoagulation, procedural type, time in bed (TIB), and mean systolic blood pressure in predicting vascular access site complications post percutaneous diagnostic cardiac catheterization (CC) and coronary intervention (PCI). Complications in this study are: hematoma, bleeding, arteriovenous fistula, pseudoaneurysm, retroperitoneal bleed, and vascular occlusion. The significance of this study lies in: (1) the population undergoing CC and PCI is large. More than 2,432,000 patients underwent these procedures in the US in 1999, and a goal of Healthy People 2010 is to increase by 20% the patients receiving artery opening therapy within one hour of symptoms. A conservative estimate of 3% vascular complications in nearly three million procedures would mean that almost 90,000 patients are affected annually. (2) Care of these patients is the responsibility of nurses. Decisions regarding TIB and control of blood pressure during sheath removal are made by nurses. Knowledge guiding nursing protocols for care post CC and PCI has not been evidence based.