Randomized Pilot Trial of Pre‐ and Postoperative Heart Failure Nurse‐Supported Care in Heart Failure Patients Requiring Noncardiac Surgery—Feasibility and Results
ABSTRACT Introduction The perioperative cardiovascular management of patients undergoing noncardiac surgery is particularly challenging in those with pre‐existing heart failure (HF). This study was designed to evaluate the effectiveness of nurse‐based pre‐ and postoperative specialized HF management...
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| Veröffentlicht in: | Clinical cardiology (Mahwah, N.J.) N.J.), 2024-06, Vol.47 (6), p.e24304-n/a |
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| creator | Herrmann, Ester J. Raghavan, Badrinarayanan Tekeste, Meaza Mantzsch, Kathleen Meybohm, Patrick Assmus, Birgit |
| description | ABSTRACT
Introduction
The perioperative cardiovascular management of patients undergoing noncardiac surgery is particularly challenging in those with pre‐existing heart failure (HF). This study was designed to evaluate the effectiveness of nurse‐based pre‐ and postoperative specialized HF management in reducing postoperative HF‐associated complications in patients with known HF undergoing noncardiac surgery.
Methods
This prospective, randomized pilot study included patients with established HF requiring intermediate‐ to high‐risk noncardiac surgery. Patients received postoperatively either standard care (control group, CG) or nurse‐supported HF management (intervention group, IG). The primary endpoint was a composite of HF‐related postoperative complications at 30 days. Secondary endpoints included length on intensive care unit, length of hospital stay, death, hospitalization for HF, and quality of life assessment using the SF‐12 questionnaire.
Results
The trial was halted prematurely for futility. A total of 34 patients (median age 70.5 [IQR 67–75] years; with 15 HfpEF, 9 HfmrEF,10 HfrEF), with an average NT‐proBNP of 1.413 [463–2.832] pg/mL were included. The IG had a lower rate of postoperative primary events (25%; n = 4) compared with the CG (33%; n = 6). There were no differences in secondary endpoints between the groups. Quality‐of‐life scores improved slightly in both groups (δ 5.6 ± 0.9 [CG] and 3.1 ± 1.2 [IG]).
Conclusion
Nurse‐based pre‐ and postoperative HF care appears to be feasible and may reduce HF‐associated complications in patients undergoing noncardiac surgery. Larger clinical trials are needed to further evaluate the effectiveness of this approach in reducing postoperative complications in this high‐risk patient population. |
| doi_str_mv | 10.1002/clc.24304 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11194970</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3072395765</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3344-6b6b004d20508e1cc5b3ebeab0944e27429bc06b9f4db968c040a272a285924a3</originalsourceid><addsrcrecordid>eNp1kstuEzEUhkcIRENhwQsgS2xgMa1vc_EKoRGhSFGJ0rK2bM9JcOWMU3tcFFZ9BBY8BM_VJ8FNSgWVWFny-fz5P_YpipcEHxGM6bFx5ohyhvmjYkIEo2XbsOZxMcGkxqWgrTgonsV4kVHcUva0OGCtoJy0eFL8Wqih92v7HXo0t86P6DxY5ZBfonmAm-sfKNfR3MfRbyCo0V4BOgEVRjRV1qUA6DSFeAuepc3GhzF7OpW37fCAm-fDMIwRLeAy2WCHFTr1g1Ght8qgsxRWELY31z-noKLV1tlxu7t7ATG5MT4vniyVi_Dibj0svkw_nHcn5ezzx0_d-1lpGOO8rHWtMeY9xRVugRhTaQYalMaCc6ANp0IbXGux5L0WdWswx4o2VNG2ym-i2GHxbu_dJL2G3uTIQTm5CXatwlZ6ZeW_lcF-lSt_JQkhgosGZ8ObO0PwlwniKNc2GnBODeBTlAw3tBFCYJbR1w_QC5_CkPvbUUxUTV1l6u2eMsHHGGB5n4ZgeTsAMg-A3A1AZl_9Hf-e_PPjGTjeA9-sg-3_TbKbdXvlb51Yv_A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3072395765</pqid></control><display><type>article</type><title>Randomized Pilot Trial of Pre‐ and Postoperative Heart Failure Nurse‐Supported Care in Heart Failure Patients Requiring Noncardiac Surgery—Feasibility and Results</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library (Open Access Collection)</source><source>PubMed Central</source><creator>Herrmann, Ester J. ; Raghavan, Badrinarayanan ; Tekeste, Meaza ; Mantzsch, Kathleen ; Meybohm, Patrick ; Assmus, Birgit</creator><creatorcontrib>Herrmann, Ester J. ; Raghavan, Badrinarayanan ; Tekeste, Meaza ; Mantzsch, Kathleen ; Meybohm, Patrick ; Assmus, Birgit</creatorcontrib><description>ABSTRACT
Introduction
The perioperative cardiovascular management of patients undergoing noncardiac surgery is particularly challenging in those with pre‐existing heart failure (HF). This study was designed to evaluate the effectiveness of nurse‐based pre‐ and postoperative specialized HF management in reducing postoperative HF‐associated complications in patients with known HF undergoing noncardiac surgery.
Methods
This prospective, randomized pilot study included patients with established HF requiring intermediate‐ to high‐risk noncardiac surgery. Patients received postoperatively either standard care (control group, CG) or nurse‐supported HF management (intervention group, IG). The primary endpoint was a composite of HF‐related postoperative complications at 30 days. Secondary endpoints included length on intensive care unit, length of hospital stay, death, hospitalization for HF, and quality of life assessment using the SF‐12 questionnaire.
Results
The trial was halted prematurely for futility. A total of 34 patients (median age 70.5 [IQR 67–75] years; with 15 HfpEF, 9 HfmrEF,10 HfrEF), with an average NT‐proBNP of 1.413 [463–2.832] pg/mL were included. The IG had a lower rate of postoperative primary events (25%; n = 4) compared with the CG (33%; n = 6). There were no differences in secondary endpoints between the groups. Quality‐of‐life scores improved slightly in both groups (δ 5.6 ± 0.9 [CG] and 3.1 ± 1.2 [IG]).
Conclusion
Nurse‐based pre‐ and postoperative HF care appears to be feasible and may reduce HF‐associated complications in patients undergoing noncardiac surgery. Larger clinical trials are needed to further evaluate the effectiveness of this approach in reducing postoperative complications in this high‐risk patient population.</description><identifier>ISSN: 0160-9289</identifier><identifier>ISSN: 1932-8737</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.24304</identifier><identifier>PMID: 38924180</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Aged ; Anesthesiology ; Antibiotics ; Cardiology ; Cardiovascular disease ; Clinical Trial Result ; Comorbidity ; Creatinine ; Edema ; Ejection fraction ; elective noncardiac surgery ; Feasibility Studies ; Female ; Heart Failure ; Hospitals ; Humans ; Intensive care ; Kidneys ; Male ; Middle Aged ; Mortality ; Nurses ; nurse‐based HF care ; Patients ; Pilot Projects ; Pneumonia ; Postoperative Care - methods ; Postoperative Complications - etiology ; Postoperative Complications - prevention & control ; Preoperative Care - methods ; preoperative HF screening ; Prospective Studies ; Quality of Life ; Questionnaires ; Surgery ; Surgical Procedures, Operative - adverse effects ; Time Factors ; Treatment Outcome ; Ventilators</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 2024-06, Vol.47 (6), p.e24304-n/a</ispartof><rights>2024 The Author(s). published by Wiley Periodicals LLC.</rights><rights>2024 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC.</rights><rights>2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3344-6b6b004d20508e1cc5b3ebeab0944e27429bc06b9f4db968c040a272a285924a3</cites><orcidid>0000-0002-3419-0282 ; 0000-0003-2658-6444</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194970/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194970/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1417,11562,27924,27925,45574,45575,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38924180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Herrmann, Ester J.</creatorcontrib><creatorcontrib>Raghavan, Badrinarayanan</creatorcontrib><creatorcontrib>Tekeste, Meaza</creatorcontrib><creatorcontrib>Mantzsch, Kathleen</creatorcontrib><creatorcontrib>Meybohm, Patrick</creatorcontrib><creatorcontrib>Assmus, Birgit</creatorcontrib><title>Randomized Pilot Trial of Pre‐ and Postoperative Heart Failure Nurse‐Supported Care in Heart Failure Patients Requiring Noncardiac Surgery—Feasibility and Results</title><title>Clinical cardiology (Mahwah, N.J.)</title><addtitle>Clin Cardiol</addtitle><description>ABSTRACT
Introduction
The perioperative cardiovascular management of patients undergoing noncardiac surgery is particularly challenging in those with pre‐existing heart failure (HF). This study was designed to evaluate the effectiveness of nurse‐based pre‐ and postoperative specialized HF management in reducing postoperative HF‐associated complications in patients with known HF undergoing noncardiac surgery.
Methods
This prospective, randomized pilot study included patients with established HF requiring intermediate‐ to high‐risk noncardiac surgery. Patients received postoperatively either standard care (control group, CG) or nurse‐supported HF management (intervention group, IG). The primary endpoint was a composite of HF‐related postoperative complications at 30 days. Secondary endpoints included length on intensive care unit, length of hospital stay, death, hospitalization for HF, and quality of life assessment using the SF‐12 questionnaire.
Results
The trial was halted prematurely for futility. A total of 34 patients (median age 70.5 [IQR 67–75] years; with 15 HfpEF, 9 HfmrEF,10 HfrEF), with an average NT‐proBNP of 1.413 [463–2.832] pg/mL were included. The IG had a lower rate of postoperative primary events (25%; n = 4) compared with the CG (33%; n = 6). There were no differences in secondary endpoints between the groups. Quality‐of‐life scores improved slightly in both groups (δ 5.6 ± 0.9 [CG] and 3.1 ± 1.2 [IG]).
Conclusion
Nurse‐based pre‐ and postoperative HF care appears to be feasible and may reduce HF‐associated complications in patients undergoing noncardiac surgery. Larger clinical trials are needed to further evaluate the effectiveness of this approach in reducing postoperative complications in this high‐risk patient population.</description><subject>Aged</subject><subject>Anesthesiology</subject><subject>Antibiotics</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Clinical Trial Result</subject><subject>Comorbidity</subject><subject>Creatinine</subject><subject>Edema</subject><subject>Ejection fraction</subject><subject>elective noncardiac surgery</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Heart Failure</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Kidneys</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nurses</subject><subject>nurse‐based HF care</subject><subject>Patients</subject><subject>Pilot Projects</subject><subject>Pneumonia</subject><subject>Postoperative Care - methods</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Preoperative Care - methods</subject><subject>preoperative HF screening</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Questionnaires</subject><subject>Surgery</subject><subject>Surgical Procedures, Operative - adverse effects</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ventilators</subject><issn>0160-9289</issn><issn>1932-8737</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1kstuEzEUhkcIRENhwQsgS2xgMa1vc_EKoRGhSFGJ0rK2bM9JcOWMU3tcFFZ9BBY8BM_VJ8FNSgWVWFny-fz5P_YpipcEHxGM6bFx5ohyhvmjYkIEo2XbsOZxMcGkxqWgrTgonsV4kVHcUva0OGCtoJy0eFL8Wqih92v7HXo0t86P6DxY5ZBfonmAm-sfKNfR3MfRbyCo0V4BOgEVRjRV1qUA6DSFeAuepc3GhzF7OpW37fCAm-fDMIwRLeAy2WCHFTr1g1Ght8qgsxRWELY31z-noKLV1tlxu7t7ATG5MT4vniyVi_Dibj0svkw_nHcn5ezzx0_d-1lpGOO8rHWtMeY9xRVugRhTaQYalMaCc6ANp0IbXGux5L0WdWswx4o2VNG2ym-i2GHxbu_dJL2G3uTIQTm5CXatwlZ6ZeW_lcF-lSt_JQkhgosGZ8ObO0PwlwniKNc2GnBODeBTlAw3tBFCYJbR1w_QC5_CkPvbUUxUTV1l6u2eMsHHGGB5n4ZgeTsAMg-A3A1AZl_9Hf-e_PPjGTjeA9-sg-3_TbKbdXvlb51Yv_A</recordid><startdate>202406</startdate><enddate>202406</enddate><creator>Herrmann, Ester J.</creator><creator>Raghavan, Badrinarayanan</creator><creator>Tekeste, Meaza</creator><creator>Mantzsch, Kathleen</creator><creator>Meybohm, Patrick</creator><creator>Assmus, Birgit</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3419-0282</orcidid><orcidid>https://orcid.org/0000-0003-2658-6444</orcidid></search><sort><creationdate>202406</creationdate><title>Randomized Pilot Trial of Pre‐ and Postoperative Heart Failure Nurse‐Supported Care in Heart Failure Patients Requiring Noncardiac Surgery—Feasibility and Results</title><author>Herrmann, Ester J. ; Raghavan, Badrinarayanan ; Tekeste, Meaza ; Mantzsch, Kathleen ; Meybohm, Patrick ; Assmus, Birgit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3344-6b6b004d20508e1cc5b3ebeab0944e27429bc06b9f4db968c040a272a285924a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Anesthesiology</topic><topic>Antibiotics</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Clinical Trial Result</topic><topic>Comorbidity</topic><topic>Creatinine</topic><topic>Edema</topic><topic>Ejection fraction</topic><topic>elective noncardiac surgery</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Heart Failure</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive care</topic><topic>Kidneys</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nurses</topic><topic>nurse‐based HF care</topic><topic>Patients</topic><topic>Pilot Projects</topic><topic>Pneumonia</topic><topic>Postoperative Care - methods</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Preoperative Care - methods</topic><topic>preoperative HF screening</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Questionnaires</topic><topic>Surgery</topic><topic>Surgical Procedures, Operative - adverse effects</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Herrmann, Ester J.</creatorcontrib><creatorcontrib>Raghavan, Badrinarayanan</creatorcontrib><creatorcontrib>Tekeste, Meaza</creatorcontrib><creatorcontrib>Mantzsch, Kathleen</creatorcontrib><creatorcontrib>Meybohm, Patrick</creatorcontrib><creatorcontrib>Assmus, Birgit</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Herrmann, Ester J.</au><au>Raghavan, Badrinarayanan</au><au>Tekeste, Meaza</au><au>Mantzsch, Kathleen</au><au>Meybohm, Patrick</au><au>Assmus, Birgit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized Pilot Trial of Pre‐ and Postoperative Heart Failure Nurse‐Supported Care in Heart Failure Patients Requiring Noncardiac Surgery—Feasibility and Results</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><addtitle>Clin Cardiol</addtitle><date>2024-06</date><risdate>2024</risdate><volume>47</volume><issue>6</issue><spage>e24304</spage><epage>n/a</epage><pages>e24304-n/a</pages><issn>0160-9289</issn><issn>1932-8737</issn><eissn>1932-8737</eissn><abstract>ABSTRACT
Introduction
The perioperative cardiovascular management of patients undergoing noncardiac surgery is particularly challenging in those with pre‐existing heart failure (HF). This study was designed to evaluate the effectiveness of nurse‐based pre‐ and postoperative specialized HF management in reducing postoperative HF‐associated complications in patients with known HF undergoing noncardiac surgery.
Methods
This prospective, randomized pilot study included patients with established HF requiring intermediate‐ to high‐risk noncardiac surgery. Patients received postoperatively either standard care (control group, CG) or nurse‐supported HF management (intervention group, IG). The primary endpoint was a composite of HF‐related postoperative complications at 30 days. Secondary endpoints included length on intensive care unit, length of hospital stay, death, hospitalization for HF, and quality of life assessment using the SF‐12 questionnaire.
Results
The trial was halted prematurely for futility. A total of 34 patients (median age 70.5 [IQR 67–75] years; with 15 HfpEF, 9 HfmrEF,10 HfrEF), with an average NT‐proBNP of 1.413 [463–2.832] pg/mL were included. The IG had a lower rate of postoperative primary events (25%; n = 4) compared with the CG (33%; n = 6). There were no differences in secondary endpoints between the groups. Quality‐of‐life scores improved slightly in both groups (δ 5.6 ± 0.9 [CG] and 3.1 ± 1.2 [IG]).
Conclusion
Nurse‐based pre‐ and postoperative HF care appears to be feasible and may reduce HF‐associated complications in patients undergoing noncardiac surgery. Larger clinical trials are needed to further evaluate the effectiveness of this approach in reducing postoperative complications in this high‐risk patient population.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>38924180</pmid><doi>10.1002/clc.24304</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3419-0282</orcidid><orcidid>https://orcid.org/0000-0003-2658-6444</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical cardiology (Mahwah, N.J.), 2024-06, Vol.47 (6), p.e24304-n/a |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals; Wiley Online Library (Open Access Collection); PubMed Central |
| subjects | Aged Anesthesiology Antibiotics Cardiology Cardiovascular disease Clinical Trial Result Comorbidity Creatinine Edema Ejection fraction elective noncardiac surgery Feasibility Studies Female Heart Failure Hospitals Humans Intensive care Kidneys Male Middle Aged Mortality Nurses nurse‐based HF care Patients Pilot Projects Pneumonia Postoperative Care - methods Postoperative Complications - etiology Postoperative Complications - prevention & control Preoperative Care - methods preoperative HF screening Prospective Studies Quality of Life Questionnaires Surgery Surgical Procedures, Operative - adverse effects Time Factors Treatment Outcome Ventilators |
| title | Randomized Pilot Trial of Pre‐ and Postoperative Heart Failure Nurse‐Supported Care in Heart Failure Patients Requiring Noncardiac Surgery—Feasibility and Results |
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