Construction and practice of community database for monitoring anticoagulation therapy after cardiac valve replacement
10.3760/cma.j.issn.1674-2907.2018.27.011
- VernacularTitle:人工心脏瓣膜置换术后康复期患者抗凝治疗监测社区数据库的建设与实践
- Author:
Mengjiao YANG
1
;
Rong CHEN
;
Yali WANG
Author Information
1. 川北医学院附属医院心胸外科
- Keywords:
Heart valve replacement;
Anticoagulation therapy;
Registered database
- From:
Chinese Journal of Modern Nursing
2018;24(27):3267-3271
- CountryChina
- Language:Chinese
-
Abstract:
Objective To construct anticoagulation monitoring database of Northeast Sichuan patients after heart valve replacement, to provide a long-term and continuous regional long-distance follow-up platform for patients with valvular heart disease in convalescent period and explore the best way to share information between superior hospitals and primary community hospitals.Methods A non-randomized, prospective controlled clinical study was conducted among 485 patients who received warfarin anticoagulation therapy and anticoagulation monitoring after cardiac valve replacement from January 2016 to September 2017 in the Affiliated Hospital of North Sichuan Medical College and Nanchong Central Hospital. All the patients were divided into outpatient follow-up group (n=242) and remote follow-up group (n=243). The outpatient follow-up group received routine clinic and telephone follow-up. The remote follow-up group realized the information sharing through the database and accepted the anticoagulation guidance provided by the primary medical institutions. Thromboembolic and hemorrhagic events associated with anticoagulation therapy and international standardized ratio (INR) were analyzed during follow-up. The quality of anticoagulation therapy was evaluated by treatment range time (TTR).Results There was no significant difference in the INR results during the follow-up time between the two groups (P>0.05). The TTR value of the outpatient and remote follow-up group was 42.3％ and 54.4％ respectively, and the difference was statistically significant (P<0.05). There was no significant difference in the total complications, serious bleeding, general bleeding and thrombosis between the two groups (P>0.05).Conclusions "Community database of valve disease anticoagulation in northern Sichuan" can effectively improve the quality of anticoagulant therapy in these patients, realize the information sharing from superior hospital patients with primary medical institutions, and ensure the convalescence after heart valve replacement of anticoagulant therapy in patients with accuracy and persistence.
