Impact of Nurse-Led Cardiovascular Risk Assessment and Management Program on 1-Year Outcomes in Patients on Hemodialysis Post Percutaneous Coronary Intervention

护士主导的心血管风险评估和管理项目对经皮冠状动脉介入治疗后接受血液透析患者1年预后的影响

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Abstract

BACKGROUND: Cardiovascular complications are a major concern for hemodialysis patients with chronic kidney disease, especially post percutaneous coronary intervention (PCI). The authors of this study investigated the impact of a nurse-led cardiovascular risk assessment and management program on 1-year outcomes in these patients. METHODS: A retrospective secondary analysis was conducted on the data of 267 patients receiving hemodialysis due to chronic kidney disease who underwent PCI. The data of patients were divided into a nurse-led care group (n = 129) receiving nurse-led care and a usual care group (n = 138) receiving usual care. The nurse-led group received personalized treatment, health education, psychological support, skill training, and regular follow-ups over 1 year. Assessments of cardiovascular risk, laboratory characteristics, psychological status, quality of life (Short Form 36 Health Survey Questionnaire), and major adverse cardiovascular events were conducted at discharge and after 1 year. RESULTS: At 1 year, the nurse-led care group showed greater reductions in cardiovascular risk compared with the usual care group. The levels of serum creatinine, uric acid, and blood lipid in the nurse-led care group were significantly improved. Psychological assessments revealed reduced anxiety and depression scores in the nurse-led care group. Short Form 36 Health Survey Questionnaire quality of life scores were higher in the nurse-led care group in several domains. The incidence of major adverse cardiovascular events, particularly cardiogenic shock, was significantly reduced in the nurse-led care group. CONCLUSION: Nurse-led cardiovascular risk management significantly improves cardiovascular risk profiles, psychological health, and quality of life, while reducing major adverse cardiovascular event incidence in patients receiving hemodialysis due to chronic kidney disease post PCI.

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