2024-03-29T09:14:02Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00028248
2023-11-16T02:57:51Z
499:508:509:2418
Gatekeeping in an inpatient rehabilitation facility to reduce morbidity and mortality due to cardiac disease : screening program using of BNP and ECG Auto-diagnosis
Kano, Naoaki
Kato, Toyonori
Tomohara, Takiko
Futamura, Yukiko
Yoshida, Shogo
Okumura, Takahiro
Maeda, Kengo
Murohara, Toyoaki
Oda, Koji
open access
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
rehabilitation
BNP
screening
cardiac complications
ECG
The Kaifukuki-Rehabilitation Ward (KRW) is a type of inpatient rehabilitation facility in Japan. In the KRW of our institute, mortality and frequency of emergency referrals in 2013 were rather high, 2.6% and 4.3%, respectively. We aimed to investigate the usefulness of an original gatekeeping system to reduce mortality and morbidity from cardiac complications, and to improve the quality of medical care in the KRW. A total of 370 consecutive patients admitted to the KRW of Kobayashi Memorial Hospital between 1 May 2015 and 31 March 2016 were enrolled in this prospective observational study. All patients underwent a screening evaluation in which we defined patients as being screen positive (SC-positive) if they had at least one of 20 diagnostic ECG codes and/or BNP level over 140 pg/dL at admission. A cardiologist provided weekly interventions to those among SC-positive patients who needed cardiac disease treatment during hospitalization. In all, 129 patients were classified as SC-positive (mean age 80 years, 124 [32%] male), and weekly intervention was needed in 28 patients, including start of cardiac medication in 17 cases. Mortality and frequency of emergency transfer due to cardiac disease during hospital stay were 0.3% and 0.3%, respectively. Our gatekeeping system involving a screening evaluation at admission and weekly intervention in selected patients by a cardiologist may be useful in reducing mortality and rate of transfer due to cardiac disease and may improve quality of medical care in KRWs.
Nagoya University Graduate School of Medicine, School of Medicine
2019-05
eng
departmental bulletin paper
VoR
https://doi.org/10.18999/nagjms.81.2.303
http://hdl.handle.net/2237/00030444
https://nagoya.repo.nii.ac.jp/records/28248
10.18999/nagjms.81.2.303
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/812.html
2186-3326
0027-7622
Nagoya Journal of Medical Science
81
2
303
312
https://nagoya.repo.nii.ac.jp/record/28248/files/14_Kano.pdf
application/pdf
406.2 kB
2019-06-13