ABSTRACT
INTRODUCTION: Implementing effective strategies to transition care for individuals with colorectal cancer is an important tool to qualify care for affected individuals, as well as contribute to the dispensation of continuous and quality care to patients. OBJECTIVE: To evaluate the effectiveness of strategies to transition from hospital care to the community compared to usual care for colorectal cancer patients to reduce hospital stay, readmissions at 30 days, and visit to the emergency department up to 30 days. METHOD: Systematic review and meta-analysis followed the recommendations of PRISMA statement, with protocol registered in PROSPERO (CRD 42,020,162,249). Searches were carried out in May 2020 in the following databases: PubMed/MEDLINE, LILACS, EMBASE, and Cochrane Central. Meta-analysis was performed using a random-effects model. The measure of effect used for dichotomous outcomes was relative risk, and for continuous outcomes, the difference of means was used, with their confidence intervals of 95%. Heterogeneity was evaluated using inconsistency statistics. RESULTS: Of 631 identified studies, seven studies were included. The meta-analysis of the studies showed a reduction in readmissions at 30 days of 32% and a significant reduction in hospital stay time of approximately one and a half days, both of which were analyzed in favor of the group of care transition interventions. CONCLUSION: The findings showed effective care transition strategies for the transition of colorectal cancer patients, such as post-discharge active surveillance program, standardized protocol of improved recovery, and telephone follow-up. TRIAL REGISTRATION: CRD42020162249.
Subject(s)
Colorectal Neoplasms , Patient Transfer , Aftercare , Colorectal Neoplasms/therapy , Humans , Length of Stay , Patient DischargeSubject(s)
Humans , Male , Female , Cardiovascular Diseases , Comparative Effectiveness Research , Clinical Nursing ResearchABSTRACT
Estudos recentes usando ecocardiografia convencional e doppler tecidual têm mostrado evidência de disfunção miocárdica em indivíduos com síndrome metabólica. Recentemente, a ecocardiografia bidimensional speckle- racking (2D-STE) emergiu como uma técnica robusta para detectar disfunção ventricular esquerda subclínica por avaliação quantitativa da deformação do miocárdio. Alguns estudos sugerem que a síndrome metabólica está associada com a deformação longitudinal do ventrículo esquerdo e, que o strain longitudinal global medido pela 2D-STE está prejudicado em sujeitos com síndrome metabólica. Pode-se inferir que a identificação precoce da disfunção ventricular esquerda e o reconhecimento do papel dos componentes da síndrome metabólica na alteração da contratilidade miocárdica ajudarão na compreensão e predição de risco de doenças cardiovasculares nessa síndrome.
Recent studies using both conventional and tissue Doppler echocardiography have gathered evidence of myocardial dysfunction in individuals with metabolic syndrome. Recently, two-dimensional speckle-tracking echocardiography (2D-STE) has become a robust method for the detection of subclinical left ventricular dysfunction through quantitative assessment of myocardial deformation. Some studies suggest that metabolic syndrome is associated with longitudinal deformation of the left ventricle and that global longitudinal strain measured by 2D-STE is impaired in individuals with metabolic syndrome. It may be inferred that the early identification of subclinical left ventricular dysfunction and the determination of the role of the components of metabolic syndrome in impaired myocardial contractility can help elucidate and predict the risk of cardiovascular diseases in this syndrome.
