Letalidade e complicações de angioplastias em hospitais públicos no Rio de Janeiro, RJ

Mallet, Ana Luisa Rocha; Oliveira, Gláucia Maria Moraes de; Klein, Carlos Henrique; Carvalho, Marcele Regine de; Silva, Nelson Albuquerque de Souza e

doi:10.1590/s0034-89102009005000078

Cited by 6 publications

(7 citation statements)

References 26 publications

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“…However, data in the Brazilian literature point to a rate of complications that cannot be neglected, capable of reaching values as expressive as 11.5% during catheterization followed by angioplasty. 15 The submission to an invasive test in patients whose high probability of CAD would justify the start of treatment may add an unnecessary risk to the propaedeutic of these patients. Emblematic works, such as that carried out by Patel et al 17 in 2010, point to a rate of 39.2% of negative tests for obstructive coronary disease (lesions lower than 20% of luminal obstruction) in 398,978 patients referred to coronary angiography in 663 hospitals, reinforcing the need for a better diagnostic stratification prior to the indication of invasive examination.…”

Section: Review Articlementioning

confidence: 99%

Performance of Diagnostic Tests for Intermediate Probabilities of Coronary Heart Disease: A Decision Making Analysis

Thiers

Barbosa

Tura

et al. 2017

International Journal of Cardiovascular Sciences

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Patients with intermediate probability of coronary disease are a diagnostic challenge and it is precisely in this population where the degree of uncertainty is greater that the diagnostic tests have their greater applicability. However, according to the current definition, subjecting to tests a population with a disease probability between 10 and 90% can generate unnecessary tests and misleading results. Knowing the characteristics of each test, as well as risks and benefits of drug treatment for coronary disease and combining this information through diagnostic thresholds brings a new perspective to decision making. To review the origin of the currently recommended concepts of intermediate probability and to determine the thresholds for diagnosis and treatment of noninvasive tests and, based on them, propose a new concept of intermediate probability of coronary disease. Through the bibliographic review, meta-analyses were extracted in which data of sensitivity, specificity, positive and negative likelihood ratio, risks and benefits of the tests and treatment were provided. Using an algorithm developed by Pauker et al. it was possible to obtain the diagnostic and treatment thresholds adjusted for each tests in question. The concept of intermediate probability of coronary disease is quite broad, ranging, according to the authors, between 10 and 90%, 1 and 92%, 15 and 85%, with different rationale. Considering the discriminatory power of each test, risks and treatment benefits, the diagnostic and treatment thresholds were defined for exercise testing (22-58%), eco-stress (10-72%), myocardial scintigraphy (12-80%), nuclear magnetic resonance (16-80%) and coronary angiotomography (6.7-81%). The decision to submit to diagnostic tests should be individualized, taking into account the diagnostic and treatment thresholds of each method in question.

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Section: Review Articlementioning

confidence: 99%

Performance of Diagnostic Tests for Intermediate Probabilities of Coronary Heart Disease: A Decision Making Analysis

Thiers

Barbosa

Tura

et al. 2017

International Journal of Cardiovascular Sciences

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“…Moreover, bleeding occurred in 5.9%, with a mortality rate of 5.6%, among which there was need for transfusion in 3.0%, with a mortality rate of 12.0%. Acute myocardial infarction occurred in 1.1%, with a mortality rate of 38% and cerebrovascular accident in 0.4%, with a mortality rate of 17.5% 4 . Regarding the CABG in the same period, complications occurred in more than 99% of deaths, while even among the survivors, 40% had complications.…”

Section: Discussionmentioning

confidence: 97%

“…Mortality rates in primary and rescue CA were 17.4% and 13.1%, and in elective CA, it was 0.8% 4 . During the same period, in 2,692 coronary artery bypass graft (CABG) records in the CRJ, a variation between hospitals was observed, from 7.0% to 14.3% in the in-hospital period, and 8.5% to 20.2 % up to one year post-hospital release and a significant association between the occurrence of complications and postoperative death (p <0.0001) 5 .…”

Section: Introductionmentioning

confidence: 94%

Desempenho e gastos do SUS com revascularizações do miocárdio no Estado do Rio de Janeiro, de 1999 a 2008

Oliveira¹,

Klein²,

Silva³

2011

Arq. Bras. Cardiol.

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. In the analysis of decreasing mortality trends due to IHD, multiple factors must be considered, including age, sex, diagnosis, therapeutic interventions and environmental and socioeconomic conditions. The studies with data recorded from clinical practice provide a view that is closer to reality than the experimental ones 3 .In a study with samples of coronary angiography (CA) records performed in public hospitals in the city of Rio de Janeiro (CRJ), from 1999 to 2003, a mean in-hospital mortality of 1.6% was observed, ranging from 0.9 % to 6.8%. Mortality rates in primary and rescue CA were 17.4% and 13.1%, and in elective CA, it was 0.8% 4 . During the same period, in 2,692 coronary artery bypass graft (CABG) records in the CRJ, a variation between hospitals was observed, from 7.0% to 14.3% in the in-hospital period, and 8.5% to 20.2 % up to one year post-hospital release and a significant association between the occurrence of complications and postoperative death (p <0.0001) 5. Therefore, regarding myocardial revascularization procedures, the minimum required performance was not observed in the SRJ 6 , representing an important financial burden for the Brazilian Public Health System (SUS), with individual and social consequences 7 .In the middle of the last decade of the twentieth century, it was estimated that 80% of medical or hospital care was financed by the Public Health System (SUS) in Brazil

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“…Os procedimentos de alta complexidade mais utilizados no tratamento das doenças crônicas cardiovasculares são a cirurgia de revascularização miocárdica (RVM) e a angioplastia coronariana (AC), além da colocação de marcapassos permanentes e estudos hemodinâmicos [2].…”

Section: Introductionunclassified

Complicações da intervenção coronária percutânea: inferência dos diagnósticos de enfermagem

Gomes¹,

Silva

Santos

2019

Enferm Bras

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Objetivos: Realizar a inferência de diagnósticos de enfermagem (DE) aplicáveis às principais complicações das intervenções coronárias percutâneas (ICP). Métodos: Revisão da literatura a partir da qual foi realizada a inferência dos DE aplicáveis nas principais complicações das ICP. Na etapa da revisão integrativa foram buscados artigos nas bases Lilacs, BDEnf e Scielo, com o descritor “angioplastia”, que abordasse as complicações relacionadas ao procedimento. Após a avaliação das complicações, foram realizadas as inferências dos DE aplicáveis. Resultados: Treze artigos compuseram o corpus de análise. Os principais DE aplicáveis inferidos são: Eliminação urinária prejudicada; Padrão respiratório ineficaz; Risco de perfusão tissular cardíaca diminuída; Perfusão tissular periférica ineficaz; Risco de perfusão tissular cerebral ineficaz; Débito cardíaco diminuído; Confusão aguda; Integridade da pele prejudicada; Integridade tissular prejudicada. Conclusão: As taxonomias de enfermagem permitem DE aplicáveis que norteiem a sistematização da assistência nas complicações das ICP.Palavras-chave: angioplastia, enfermagem cardiovascular, diagnóstico de enfermagem, cardiologia.

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Letalidade e complicações de angioplastias em hospitais públicos no Rio de Janeiro, RJ

Abstract: The cardiac in-hospital mortality was high when PTCA was performed for a patient with ST elevation acute myocardial infarction. Elective PTCA had mortality and complications levels above the expected in four public hospitals in the main city of Rio de Janeiro.

Cited by 6 publications

References 26 publications

Performance of Diagnostic Tests for Intermediate Probabilities of Coronary Heart Disease: A Decision Making Analysis

Performance of Diagnostic Tests for Intermediate Probabilities of Coronary Heart Disease: A Decision Making Analysis

Desempenho e gastos do SUS com revascularizações do miocárdio no Estado do Rio de Janeiro, de 1999 a 2008

Complicações da intervenção coronária percutânea: inferência dos diagnósticos de enfermagem

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