在心力衰竭住院患者中的家庭时间,死亡率和再入院:在IMPLEMENT-HF之前的基线
Amber B Tang1, Nicole Solomon2, Karen Chiswell2
1Department of Medicine, University of California Los Angeles (A.B.T.).
Circulation. Heart failure
|October 9, 2024
概括
心力衰竭患者在出院后91.2%的时间都在家中度过. 高死亡率显著影响了家庭时间,突出了改善心力衰竭管理干预措施的需要.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 患者为中心的结果.
背景情况:
- 家庭时间,定义为在医疗机构之外活着度过的时间,是一个新兴的以患者为中心的结果.
- 对于心力衰竭 (HF) 患者的家庭时间存在有限的研究.
- 质量改善干预措施对高频家庭时间的影响尚未研究.
研究的目的:
- 为住院治疗心力衰竭的医疗保险受益人建立基线家庭时间指标.
- 评估出院后的回家时间,死亡率和再入院率.
- 为IMPLEMENT-HF质量改进计划奠定基础.
主要方法:
- 从Get With the Guidelines-心力衰竭注册表 (2019-2021) 中分析了因心力衰竭住院的医疗保险受益人 (≥65岁).
- 30天和1年的出院后回家时间,死亡率和再入院率的计算.
- 包括437个地点的66,019名患者.
主要成果:
- 平均1年的家庭时间为333天;只有22.1%的患者有100%的家庭时间.
- 老年患者和黑人患者在家时间显著减少.
- 观察到高1年心力衰竭再入院率 (29.8%) 和所有原因死亡率 (37.0%).
结论:
- 在出院后的一年内,心力衰竭患者平均在家中度过了91.2%的时间.
- 高死亡率是减少家居时间的主要驱动因素.
- 调查结果为IMPLEMENT-HF计划提供了重要的预实施基准,以评估质量改进计划.
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