Smoking cessation after acute myocardial infarction: effects of a nurse-managed intervention
Article Abstract:
Studies have shown that the rates of second heart attack (myocardial infarction or MI), sudden cardiac deaths, and death are lower among people who stop smoking after a first acute myocardial infarction than among those who continue to smoke. Programs to encourage smoking cessation are not successful in all patients. Some studies suggest that 50 percent or more of smokers who quit at first resume smoking. One of 12 recent uncontrolled studies, however, reported a 62 percent self-reported one-year quit rate. In that study, physicians told patients they had to quit, and nurses provided follow-up advice. While approaches to smoking cessation have changed over the past few years, they all require more time with patients than physicians can give in a practice setting. This study was designed to evaluate how effective nurse intervention would be in a smoking cessation program. This program was initiated while the patient was in the hospital, conducted mostly by telephone, and focused on preventing relapse. The program significantly increased smoking cessation rates in the first 12 months after AMI; 71 percent of the 86 patients in the intervention group had stopped smoking compared with 45 percent of 87 patients in the usual care group. When figures were adjusted for those lost to follow-up who were presumed to have started smoking again, the figures were 61 percent as compared with 32 percent for the two groups. While it is not possible to determine how the individual components of this program contributed to its success, starting the program before the patient left the hospital was deemed important. One nurse, working part time, can effectively coordinate smoking cessation programs for more than 120 patients during the first six months after cessation. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1990
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Renal dysfunction after myocardial revascularization: risk factors, adverse outcomes, and hospital resource utilization
Article Abstract:
Some patients who have myocardial revascularization may develop kidney disease. Myocardial revascularization consists of techniques to open blocked arteries to restore blood flow to the heart. In a study of 2,222 patients who had this treatment, 171 developed postoperative kidney disease. Thirty developed kidney failure and had to have dialysis. These patients had longer hospital stays and were often discharged to an extended-care facility. Patients 70 years old and older had a high risk of kidney disease as did those with existing kidney disease, heart failure and diabetes.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1998
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