1.Comparison of Anticoagulant Efficacy and Safety of Dabigatran Etexilate and Warfarin in the Treatment of Non-valvular Atrial Fibrillation
Hongyu GUO ; Yongke DUAN ; Yan HONG ; Guanchang CHENG
China Pharmacy 2017;28(33):4661-4663
OBJECTIVE:To compare anticoagulant efficacy and safety of dabigatran etexilate and warfarin in the treatment of non-valvular atrial fibrillation(NVAF). METHODS:In retrospective analysis,360 NVAF patients were divided into control group (180 cases)and observation group(180 cases)according to therapy plan. Control group was given Warfarin sodium tablet with ini-tial dose of 2.5 mg orally,once a day,adjusted dosage according to INR. Observation group was given Dabigatran etexilate cap-sule 150 mg with warm water,twice a day,during or after meal. The levels of ALT,AST and INR,the occurrence of ADR were observed in 2 groups before treatment and 1,3 month after treatment. RESULTS:There was no statistical significance in the levels of ALT or AST between 2 groups before and after treatment (P>0.05). Before treatment,there was no statistical significance in INR between 2 groups (P>0.05),1,3 months after treatment,INR in control group was significantly higher than before treat-ment,with statistical significance(P<0.05);there was no statistical significance in the INR of observation group before and after treatment(P>0.05);but INR of 2 groups ranged were in normal range. There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Anticoagnlant efficacy of dabigatran etexilate is significantly better than war-farin for NVAF. Both have similar safety.
2.Construction of equipment alarm fatigue risk prediction model for pediatric ICU nurses
Qiaohong LIU ; Jie WANG ; Yongke DUAN ; Huiyue ZHOU ; Ruihua QI
Chinese Journal of Modern Nursing 2022;28(22):3016-3021
Objective:To explore the influencing factors of instrument and equipment alarm fatigue risk of nurses in pediatric intensive care unit (ICU) , establish a prediction model and verify its prediction efficiency.Methods:A multi-stage sampling method was used to select 300 pediatric ICU nurses from 2 tertiary children's specialized hospitals in Henan Province from October 2020 to March 2021 as the research objects for model construction. A total of 300 questionnaires were distributed and 225 valid questionnaires were recovered. From April to May 2021, 110 pediatric ICU nurses in Henan Children's Hospital were selected for model validation, 110 questionnaires were distributed and 100 valid questionnaires were recovered. A self-made baseline rating scale was used to collect relevant baseline information. The medical equipment alarm management questionnaire and the equipment alarm fatigue related scale were used for investigation. The Logistic regression model was used to establish the prediction model, Hosmer-Lemeshow test was used to test the fitting effect of the model and the receiver operating characteristic curve was used to evaluate the prediction value.Results:The 225 pediatric ICU nurses scored (48.67±4.35) for medical equipment alarm management factors, (39.67±3.67) for obstacles to medical equipment alarm management and (22.32±2.83) for clinical alarm fatigue. The results of multivariate analysis showed that the factors of age less than 30 years old, working years less than 5 years, working with illness, nurses with professional titles below, shift work, no habit of setting medical equipment alarms, and medical equipment management factors were all pediatric ICU nurses' equipment alarm fatigue. The independent risk factor of ICU ( P<0.05) . In this study, a prediction model was finally constructed. The area under the receiver operating characteristic curve (AUC) of the model was 0.887, the sensitivity was 0.891 and the specificity was 0.843. The validation data results showed that AUC value of the model was 0.901, the sensitivity was 0.912 and the specificity was 0.857. Conclusions:Pediatric ICU nurses have different degrees of equipment alarm fatigue. This research model can reliably predict the alarm fatigue risk of their equipment and equipment, suggesting that high-risk factors should be paid attention to and timely intervention measures should be carried out to reduce the risk of related adverse events.