Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: There is wide variation in stress test utilization before major vascular surgery and adherence to practice guidelines is unclear. We defined rates of stress test compliance at our institution and led a quality improvement initiative to improve compliance with American Heart Association (ACC/AHA) guidelines.
Methods: We implemented a stress testing order set in the electronic medical record at one tertiary hospital. We reviewed all patients who underwent elective, major vascular surgery in the 6 months before (Jan 1, 2022 - Jul 1, 2022) and 6 months after (Aug 1, 2022 - Jan 31, 2023) implementation. We studied stress test guideline compliance, changes in medical or surgical management, and major adverse cardiac events (MACE).
Results: Before order set implementation, 37/122 patients (30%) underwent stress testing within the past year (29 specifically ordered preoperatively) with 66% (19/29) guideline compliance. After order set implementation, 50/173 patients (29%) underwent stress testing within the past year (41 specifically ordered preoperatively) with 80% (33/41) guideline compliance. In the pre- and postimplementation cohorts, stress testing led to a cardiovascular medication change or preoperative coronary revascularization in 24% (7/29) and 27% (11/41) of patients, and a staged surgery or less invasive anesthetic strategy in 14% (4/29) and 4.9% (2/41) of patients, respectively. All unindicated stress tests were surgeon-ordered and none led to a change in management. There was no change in MACE after order set implementation.
Conclusions: Electronic medical record-based guidance of perioperative stress testing led to a slight decrease in overall stress testing and an increase in guideline-compliant testing. Our study highlights a need for improved preoperative cardiovascular risk assessment prior to major vascular surgery, which may eliminate unnecessary testing and more effectively guide perioperative decision-making.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727674 | PMC |
| http://dx.doi.org/10.1177/1358863X241247537 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Airway obstruction and gender affect arterial stiffness in children with cystic fibrosis.
Turk J Pediatr
September 2025
Department of Cardiorespiratory Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye.
Background: Vascular changes are observed in children with cystic fibrosis (cwCF), and gender-specific differences may impact arterial stiffness. We aimed to compare arterial stiffness and clinical parameters based on gender in cwCF and to determine the factors affecting arterial stiffness in cwCF.
Methods: Fifty-eight cwCF were included.
Association of problematic internet use with health-related daily habits in adolescents: evidence from a school-based survey.
Turk J Pediatr
September 2025
Department of Pediatrics, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Türkiye.
Background: With the development of technology, easier access to the internet and its excessive use have led to problematic internet use (PIU). The prevalence of PIU and its association with lifestyle behaviors in adolescents have become subjects of increasing academic interest. This study aimed to determine the prevalence of PIU among Turkish high school students and to investigate its association with sleep, physical activity and dietary habits.
View Article and Find Full Text PDFBackground: The study aimed to adapt a stress and well-being intervention delivered via a mobile health (mHealth) app for Latinx Millennial caregivers. This demographic, born between 1981 and 1996, represents a significant portion of caregivers in the United States, with unique challenges due to higher mental distress and poorer physical health compared to non-caregivers. Latinx Millennial caregivers face additional barriers, including higher uninsured rates and increased caregiving burdens.
View Article and Find Full Text PDFTuneable multidirectional mechanical attributes of novel sectionally nonlinearly functionally graded femur and cranial bone implants with triply periodic minimal surfaces.
PLoS One
September 2025
Mechanical and Nuclear Engineering Department, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.
Sectionally nonlinearly functionally graded (SNFG) structures with triply periodic minimal surface (TPMS) are considered ideal for bone implants because they closely replicate the hierarchical, anisotropic, and porous architecture of natural bone. The smooth gradient in material distribution allows for optimal load transfer, reduced stress shielding, and enhanced bone ingrowth, while TPMS provides high mechanical strength-to-weight ratio and interconnected porosity for vascularization and tissue integration. Wherein, The SNFG structure contains sections with thickness that varies nonlinearly along their length in different patterns.
View Article and Find Full Text PDFExploring the limits of exercise capacity in adults with type II diabetes.
PLoS One
September 2025
Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Objective: This study investigates the mechanisms behind exercise capacity in adults with type 2 diabetes mellitus (T2DM), focusing on central and peripheral components, as described by the Fick equation.
Methods: A cross-sectional study of 141 adults with T2DM was conducted, using cardiopulmonary exercise testing, near-infrared spectroscopy (NIRS) and exercise echocardiography. Participants with sufficient-quality NIRS data were stratified into tertiles based on percentage predicted VO₂peak.