扩大慢性心力衰竭的视野:与常规护理相比,多学科,家庭干预的影响
Sally C Inglis1, Sue Pearson, Suzette Treen
1University of Queensland, Faculty of Health Sciences, Brisbane, Queensland, Australia.
Circulation
|November 23, 2006
概括
慢性心力衰竭的家庭干预 (HBI) 显著增加了存活时间的两倍,并减少了住院治疗与常规护理相比. 这种由护士领导的计划对于长期的患者管理来说是非常具有成本效益的.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 慢性心力衰竭 (CHF) 管理计划的长期有效性尚未得到充分证实.
- 患有心血管疾病的老年患者在住院后经常面临显著的发病率和死亡率.
研究的目的:
- 评估护士领导的多学科家庭干预 (HBI) 对慢性心力衰竭患者的长期影响.
- 为了比较HBI的结果与通常的退院后护理 (UC) 在典型的寿命中.
主要方法:
- 一项随机对照试验,涉及297名住院后心血管疾病的老年患者.
- 患者被分配到HBI (n=149) 或UC (n=148) 中.
- 随访延长至10年,评估所有原因的死亡率,无事件生存率,再入院和成本效益.
主要成果:
- 与UC (22个月) 相比,HBI组 (40个月) 的中位生存时间几乎翻了一番 (P<0.001).
- 在HBI (77%) 与UC (89%) (调整后RR 0.74) 中,全因死亡率较低.
- 在HBI中,每名患者每年表现出长期无事件生存率和显著较低的再入院率和住院日数.
结论:
- 基于家庭的干预 (HBI) 显著改变慢性心力衰竭的自然史.
- HBI是一个成本和时间有效的策略,用于长期管理CHF.
- 护士主导的多学科HBI改善了老年CHF患者的生存率,并减少了老年CHF患者的复发性住院.
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