在急性不补偿性心力衰竭中,口腔循环利尿剂在出院前的持续时间和医院再入院之间的关联:一个多中心的回顾性队列研究
Mohannad Alshibani1, Samah Alshehri1, Nayyra Fatani1
1Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
Medicine
|December 10, 2024
概括
在急性不补偿性心力衰竭患者服用口服循环利尿剂之前延长观察,可显著减少30天的再入院. 较长的观察期改善了患者的结果,并减少了医院再入院.
科学领域:
- 心脏病学 心脏病学
- 临床药房 临床药房
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在急性不补偿性心力衰竭 (ADHF) 患者在出院前启动口服循环利尿剂的最佳时间存在不确定性.
- 服用口服利尿剂的早期出院可能与再入院率的增加有关.
研究的目的:
- 为了研究在ADHF患者转换为口服循环利尿剂之前,在出院前延长观察时间对医院再入院的影响.
- 为了确定更长的观察期是否会影响30,60和90天的所有原因和心力衰竭特定的再入院率.
主要方法:
- 在沙特阿拉伯,一项涉及400名成年ADHF患者的多中心回顾性研究,这些患者接受了口服循环利尿剂.
- 根据观察时间,患者被分为两组:24小时以下 (<24小时) 和24小时以上 (≥24小时).
- 主要结局是30天所有原因的再入院;次要结局包括60天和90天的再入院和心力衰竭的再入院.
主要成果:
- 与24小时或更长时间 (OR=1.83,P=0.017) 的患者相比,观察时间少于24小时的患者在30天内因任何原因重新入院的次数显著增加 (OR=1.83,P=0.017).
- 基线特征在各组之间相似,除了住院时间和总观察时间.
- 较长的观察持续时间与所有原因的30天再入院率的下降显著相关.
结论:
- 开始服用口服循环利尿剂的ADHF患者在出院前观察时间较长 (≥24小时) 与30天所有原因再入院的减少有关.
- 标准化启动口腔循环利尿剂的观察期对于改善ADHF管理中的出院后结果至关重要.
- 这一发现支持优化心力衰竭患者护理方案的过渡.
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