Date of Award

January 2019

Document Type

Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Jessica Coviello

Abstract

Abstract

The number of hematopoietic stem cell transplants (HSCT) performed in the U.S. and worldwide is increasing. Cardiac events have been well described in HSCT, and incidence and type of cardiac events have not changed over recent decades. This study adds to the body of evidence in describing incidence and type of cardiac events experienced by an allogeneic and autologous HSCT population at one institution from 2012-2017. Sixty-five patients (9.8%) experienced cardiac events, including atrial arrhythmia (N = 39), acute heart failure (N = 9), acute coronary syndrome (N = 7), new onset hypertension (N = 9), with a few instances of bradycardia, ventricular arrhythmia, pericardial effusion, and pericarditis. Our multivariable regression analysis identified age (older), creatinine (higher) and history of coronary artery disease to significantly correlate with risk of cardiac event (p = 0.005, p = 0.039, p = 0.038 respectively). Patients developing a CE had an increased risk of death within one year (11% vs. 32%, p <0.001). We review our results in context of other important HSCT cardiac studies to illuminate the most relevant factors of medical history, laboratory data, and cardiac measurements that will identify patients at higher risk, allowing for intervention to improve HSCT outcomes.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 10/19/2022

Share

COinS