ABSTRACT
Background: Cerebral stroke (CS) remains a leading cause of mortality worldwide. In addition to effective treatment, nursing intervention plays a pivotal role in the rehabilitation of CS patients. Objective: This study aims to assess the impact of meticulous care integrated with risk management on rehabilitating cerebral stroke patients. The objective is to provide valuable clinical insights for the management of CS patients. Methods: A comparative observational study was conducted, including a total of 180 CS patients admitted between February 2020 and February 2022 were selected for this study. Among them, 98 patients received meticulous care combined with risk management (research group), while 82 patients underwent routine nursing intervention (control group). We analyzed the changes in the Fugl-Meyer Motor Assessment scale, National Institute of Health Stroke Scale, Activities of Daily Living scale, and Barthel Index before and after the care interventions. Additionally, we documented nursing risk events during treatment, assessed nursing quality scores, and conducted a quality-of-life survey after a one-year follow-up. Results: The research group exhibited significantly higher post-care scores in the Fugl-Meyer Motor Assessment, Activities of Daily Living, and Barthel Index, along with lower National Institute of Health Stroke Scale scores, compared to the control group (P < .05). Furthermore, the research group experienced a lower incidence of nursing risk events and demonstrated higher nursing quality (P < .05). During the prognostic follow-up, the research group displayed a superior quality of life compared to the control group (P < .05). Conclusions: Meticulous care integrated with risk management enhances the recovery of CS patients and is strongly recommended for clinical implementation.
Subject(s)
Stroke Rehabilitation , Stroke , Humans , Activities of Daily Living , Quality of Life , Psychological Well-Being , Stroke/therapy , PrognosisABSTRACT
BACKGROUND: Neoadjuvant chemoradiotherapy followed by esophagectomy is the standard treatment for patients with locally advanced esophageal squamous cell carcinoma (ESCC). This study explored correlations of clinical factors and dose-volume histogram (DVH) parameters with postoperative cardiopulmonary complications and predicted their risk by establishing a nomogram model. METHODS: Clinical and DVH parameters of ESCC patients who underwent trimodality treatment from 2002 to 2020 were collected. Postoperative cardiopulmonary complications were recorded. Logistic regression analysis was applied, and a nomogram model was constructed. Area under the receiver operating characteristic (AUC) curve, calibration curve, and decision curve analyses were performed to evaluate the performance of the nomogram. RESULTS: Of the 307 ESCC patients enrolled in this study, 65 (21.2%) experienced pulmonary complications and 57 (18.6%) experienced cardiac complications. The following six risk factors were identified as independent risk factors for pulmonary complications by multivariate logistic regression analyses in the integrated model: male sex (odds ratio [OR], 3.26; 95% confidence interval [CI], 1.27-9.70; P = 0.021), post-radiation therapy (RT) forced expiratory volume in 1 s (FEV1) (OR, 0.51; 95% CI 0.28-0.90; P = 0.023), mean lung dose (MLD) (OR, 1.13; 95% CI 1.01-1.28; P = 0.041), and pre-RT monocyte (OR, 8.36; 95% CI 1.23-11.7; P = 0.03). The AUC of this integrated model was 0.705 (95% CI 0.64-0.77). The paclitaxel and cisplatin (TP) concurrent chemotherapy regimen was the independent predictor of cardiac complication (OR, 2.50; 95% CI 1.22-5.55; P = 0.016). CONCLUSIONS: For ESCC patients who underwent trimodality treatment, male sex, post-RT FEV1, MLD, and pre-RT monocyte were confirmed as significant predictors of postoperative pulmonary complications. A nomogram model including six risk factors was further established. The independent predictor of cardiac complication was TP concurrent chemotherapy.
