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在充血性心力衰竭中进行家庭干预:对再入院和生存的长期影响
Simon Stewart1, John D Horowitz
1Division of Health Sciences, University of South Australia. simon.stewart@unisa.edu.au
Circulation
|June 19, 2002
概括
慢性充血性心力衰竭 (CHF) 的长期家庭干预措施显著降低了再入院并提高了生存率. 这些好处持续存在,证明了多学科护理计划的持久影响.
科学领域:
- 心脏病学 心脏病学
- 老年学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 慢性充血性心力衰竭 (CHF) 的退院后计划的长期疗效尚未得到充分证实.
- 评估干预措施对无事件生存,再录取和医疗保健成本的持续影响至关重要.
研究的目的:
- 预期评估多学科家庭干预 (HBI) 在CHF患者的长期影响.
- 为了比较HBI和常规护理之间的无事件生存率,死亡率,再接收率和相关成本.
主要方法:
- 一项前性研究,涉及随机分配到HBI (n=149) 或通常护理 (n=148) 的CHF患者.
- 平均随访时间为4.2年.
- 分析主要终点,包括意外再入院或死亡,生存时间和医疗保健费用.
主要成果:
- 在HBI组中发生的主要事件 (无计划的再入院或死亡) 显著减少 (0.21对0.37事件/患者/月;P<0.01).
- 在HBI组中,无事件生存时间的中位数被延长了 (7 vs 3个月;P<0.01).
- HBI与死亡率降低 (56%与65%相比; P=0.06),延长存活 (中位数为40与22个月; P<0.05) 和少于再入院 (0.17与0.29/患者/月; P<0.05) 相关,中位数成本较低 ($A325与A660/月; P<0.01).
结论:
- 在减少心血管疾病患者意外再入院的过程中,HBI的有益效果在长期持续.
- 家庭干预与慢性心血管疾病患者的生存时间显著延长有关.
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