BACKGROUND Coma has been considered as a valuable symptom of heatstroke. This study aimed to evaluate the role of the Glasgow Coma Scale (GCS) as an indicator of prognosis of patients with heatstroke. MATERIAL AND METHODS From Jan 1st, 2013 to Dec 31st, 2020, the clinical courses of 257 heatstroke patients from 3 medical centers in Guangdong, China, were observed. Diagnosis of heatstroke was made according to Expert Consensus in China. GCSs were calculated on the 1st, 3rd, and 5th days after admission to intensive care units (ICUs). GCS £8, as a coma criterion, was employed to predict the outcomes. RESULTS Seventy-five patients (29.18%) were comatose at admission. Twenty-seven (10.50%) patients, including 24 (24/75, 32.00%) coma patients and 3 (3/182,1.65%) non-coma patients died during ICU stay (P<0.0001). Patients with GCS ≤8 had a 2-fold higher risk of death as compared with those with GCS >8. The area under curves (AUCs) of GCSs on the 1st, 3rd, and 5th days to predict mortality were 0.81 (0.70-0.91), 0.91 (0.84-0.98), and 0.91 (0.82-0.99), respectively. Each additional 1 year of age, 1/min of respiratory rate (RR), and 1% of hematocrit (HCT) increased the risk of death of coma patients by 3%, 6%, and 4%, respectively (all P≤0.05). Patients with improving GCSs had lower mortality rates than non-improving patients (5.71% vs 55.00%, P<0.0001) within 5 days after admission. CONCLUSIONS GCS ≤8 at admission predicted worse outcomes in heatstroke patients, which possibly enhanced the risks of death for other factors, including age, RR, and HCT.
Coma , Heat Stroke , Humans , Infant , Retrospective Studies , Glasgow Coma Scale , Prognosis , Coma/diagnosis , Intensive Care Units , Heat Stroke/diagnosis
Objective@#To construct an evidence-based nursing plan for stroke patients with dysphagia for nursing by searching guidelines and using Delphi method.@*Methods@#The evidence-based nursing plan for stroke patients with dysphagia was constructed by literature review and guideline search. 15 experts from neurology, rehabilitation and nursing were selected to participate in two rounds Delphi consultation.@*Results@#The two-round response rates were 15/15. The expert authority coefficient was 0.877. The coordination coefficients were 0.180, 0.132 and 0.185 (P<0.05). The final plan included 4 first-grade indicators, 14 second-grade indicators and 20 third-grade indicators.@*Conclusion@#The evidence-based nursing intervention plan for stroke patients with dysphagia based on Delphi method is reliable, which can provide reference for the rehabilitation nursing of stroke patients with dysphagia.
Objective To construct an evidence-based nursing plan for stroke patients with dysphagia for nursing by searching guidelines and using Delphi method. Methods The evidence-based nursing plan for stroke patients with dysphagia was constructed by literature review and guideline search. 15 experts from neurology, rehabilitation and nursing were selected to participate in two rounds Delphi consultation. Results The two-round response rates were 15/15. The expert authority coefficient was 0.877. The coordination coefficients were 0.180, 0.132 and 0.185 (P＜0.05). The final plan included 4 first-grade indicators, 14 second-grade indicators and 20 third-grade indicators. Conclusion The evidence-based nursing intervention plan for stroke patients with dysphagia based on Delphi method is reliable, which can provide reference for the rehabilitation nursing of stroke patients with dysphagia.
Objective To investigate the symptom clusters and their effect on daily life among the adolescents with osteosarcomaduring chemotherapy. Methods A total of 127 adolescents with osteosarcoma undergoing chemotherapy were enrolled and investigated by using the Chinese version of the M.D.Anderson Symptom Inventory (MDASI-C).Then exploratory factor analysis and regression analysis were used to identify symptom clusters and the associations of symptom clusters and daily life respectively. Results For adolescents with osteosarcoma during chemotherapy, the high incidence of symptoms are loss of appetite[96.06％(122/127)], nausea[94.49％(120/127)] and fatigue[91.33％(116/127)], the severe sympyoms are loss of appetite[4.00(3.00,5.00) points], fatigue [4.00(3.00,5.00) points] and nausea[3.5(3.00,5.00) points]. Four symptom clusters were identified: gastrointestinal symptom cluster, pain-related symptom cluster, respiratory symptom cluster and neuro symptom cluster. Symptom clusters except neuro symptom cluster were predictors of distress in daily life. Conclusions The incidence of symptoms in adolescents with osteosarcoma during chemotherapyis high. Several symptom clusters significantly affect their daily life . Medical staff should pay attention to the symptom clusters and provide effective symptom management to improve patients'quality of life.
