75岁以上经皮冠状动脉介入治疗术患者电话随访现况调查及对策分析

Telephone Follow-up of Patients over 75 Years of Age after Percutaneous Coronary Intervention

目的探讨75岁以上行经皮冠状动脉介入治疗术治疗的患者电话随访过程中存在的问题,寻求提高随访成功率、改进随访质量的有效策略。方法 2016年1月至2017年12月,便利抽样法选取入住某三级甲等医院75岁以上行经皮冠状动脉介入治疗的患者为研究对象,进行电话随访,并统计分析随访情况。结果总随访628例,其中未失访464例、失访164例,总失访率为26.1%。其中成功随访用药情况281例,占60.56%;成功随访生活方式情况244例,占52.59%;成功随访到心血管不良事件52例,占11.21%。在电话随访失败的原因中,拒访占45.1%(74/164)、无人接听占20.7%(34/164)、空号占15.9%(26/164)、电话错误占9.1%(15/164)、停机占3.7%(6/164)、关机占3.7%(6/164),未留电话1.8%(3/164)。结论高龄冠状动脉硬化性心脏病患者介入治疗后电话随访失访率高,出院后的延续性治疗难以保证,需采取对应的措施进行改进。

Objective To explore the issues existed in telephone follow-up of patients over 75 years of age after percutaneous coronary intervention,and to provide effective strategies for improving the success rate and the quality of telephone follow-up. Methods The elderly patients after percutaneous coronary intervention in the hospital from January 2016 to December 2017 were selected and received telephone follow-up. Results Among 628 patients,the frequency of lost to follow-up was 26.1%（164 cases）.Additionally, 281 cases were followed up for medication, accounting for 60.56%; and 244 cases were followed up for life style, accounting for 52.59%;and 52 cases were followed up for complications,accounting for 11. 21%. Among 164 failed telephone follow-up cases,74 （45.1%） cases refused to follow-up,34 （20. 7%） cases with no answer to the call,26（15.9%） pa tients with dead number,15 （9.1%） cases were wrong number, 6 （3. 7%） cases stopped using the phone number, 6 （3.7%） cases shutdown the phone and 3 （1.8%） cases did not give the phone number. Conclusions There were high rate of lost to follow-up in elderly patients after percutaneous coronary intervention with telephone follow-up, and it is difficult to ensure the continuous treatment after discharge,so effective measures should be taken to improve current situation.