基于设备的远程管理心力衰竭途径与结果的关联:TriageHF Plus现实世界的评估
Fozia Zahir Ahmed1,2, Camilla Sammut-Powell3, Glen P Martin3
1Department of Cardiology, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
ESC heart failure
|May 7, 2024
概括
基于设备的心力衰竭 (HF) 临床途径TriageHF Plus在患有HF和心脏植入式电子设备的患者中显著减少了58%的住院治疗. 这一途径还改善了HF症状,证明了其在治疗心力衰竭方面的有效性.
科学领域:
- 心脏病学 心脏病学
- 数字健康数字健康
- 医疗保健服务研究 医疗服务研究
背景情况:
- 临床途径改善心力衰竭 (HF) 的结果.
- 患有HF的患者通常具有心脏植入式电子设备,但设备衍生的风险得分在护理组织中未得到充分利用.
- TriageHF Plus是一种新的基于设备的HF临床途径 (DHFP),使用远程监控警报.
研究的目的:
- 评估TriageHF Plus DHFP对住院治疗的影响.
- 评估与TriageHF Plus途径相关的劳动力负担.
- 为了确定设备衍生风险分层在管理高频的有效性.
主要方法:
- 一个多站点的前性研究,将TriageHF Plus与常规护理进行比较.
- 对警报引发的评估对适当性和工作负载的分析.
- 负二项式回归与反向概率治疗权重以估计住院率.
- 对于COVID-19前期的特异性敏感性分析.
主要成果:
- 与常规护理相比,TriageHF Plus队列 (n=443) 的住院率降低了58% (IRR:0.42,P=0.004).
- 警报在43%的病例中引发了急性医疗问题,其中50项评估表明急性HF需要临床行动.
- 在COVID-19前的分析显示,住院病例减少了31% (P=0.077).
- 每次评估平均为10分钟,在最初有症状的患者中,在59%的患者中观察到HF症状的改善.
结论:
- TriageHF Plus代表了一个 DHFP 的大规模,现实世界的评估.
- TriageHF Plus途径有效地减少了心力衰竭患者因各种原因住院的病例.
- 这种基于设备的方法改善了HF症状,并证明了显著的临床效用.
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