In patients who have stroke, maximum heart rate at the time of stroke has a significant impact on recurrent stroke, myocardial infarction and mortality after one year.
TITLE
Effect of Heart Rate on 1-Year Outcome for Patients With Acute Ischemic Stroke.
JOURNAL
Journal of the American Heart Association
DOI
10.1161/JAHA.122.025861
Author(s)
Lee|Keon-Joo|KJ|0000-0002-6571-7091; et al
Abstract
Background Previous literature about the effect of heart rate on poststroke outcomes is limited. We attempted to elucidate (1) whether heart rate during the acute period of ischemic stroke predicts subsequent major clinical events, (2) which heart rate parameter is best for prediction, and (3) what is the estimated heart rate cutoff point for the primary outcome.
https://www.focalize.md/find-journals/?a=euiE4YABjZS8LUbgu5D-
This discussion for end of life care is relevant for more than just COPD patients. Palliative care earlier in a disease process can help improve quality of life and even prognosis but often discussions about end of life are delayed.
TITLE
Clinician Perspectives on How to Hold Earlier Discussions About Palliative and End-of-Life Care With Chronic Obstructive Pulmonary Disease Patients: A Qualitative Study.
JOURNAL
Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association
DOI
10.1097/NJH.0000000000000858
Author(s)
Tavares|Nuno|N|;Jarrett|Nikki|N|;Wilkinson|Tom|T|;Hunt|Katherine|K|
Abstract
Chronic obstructive pulmonary disease is associated with progressive symptoms and increased treatment burden, especially at the end of life. However, most patients do not receive palliative care until late in their lives or discuss their end-of-life preferences with clinicians. This study explored clinicians' perspectives on the timing and nature of palliative care discussions. Qualitative interviews were conducted with 7 physicians and 7 nurses working in primary and secondary care settings. Data were analyzed using a thematic analysis. Participants advocated for early, gradual, and informed palliative and future care discussions, because these discussions were thought to be less traumatic and better accepted by patients. Despite this, patient- and clinician-related barriers severely affected clinicians' ability to start discussions at earlier stages. Participants felt many patients were not ready for these discussions and feared damaging hope if the subject was broached. Therefore, clinicians delayed discussions until patients approached the end of life. Stand-alone conversations about and near the end of life were described as current practice; however, clinicians believed these discussions reduced patients' hope and were potentially upsetting. Instead, individualized early, regular, and gradual discussions about immediate and long-term care plans were thought to be less negative and be better accepted.
https://www.focalize.md/find-journals/?a=NuQz2IABjZS8LUbgJA96
