EECP Significantly Lower Readmission of Patients with Heart Failure 體外反搏治療顯著減低心臟衰竭患者的 再入院 率

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EECP Significantly Lower Readmission of Patients with Heart Failure

Heart failure (HF) affects millions of Americans and causes financial burdens because of the need for rehospitalization. For this reason, health care systems and patients alike are seeking methods to decrease readmissions. We assessed the potential for reducing readmissions of patients with postacute care HF through an educational program combined with enhanced external counterpulsation (EECP). We examined 99 patients with HF who were referred to EECP centers and received heart failure education and EECP treatment within 90 days of hospital discharge from March 2013 to January 2015. We compared observed and predicted 90-day readmission rates and examined results of 6-minute walk tests, Duke Activity Status Index, New York Heart Association classification, and Canadian Cardiovascular Society classification before and after EECP. Patients were treated with EECP at a median augmentation pressure of 280 mm Hg (quartile 1 = 240, quartile 3 = 280), achieved as early as the first treatment. Augmentation ratios varied from 0.4 to 1.9, with a median of 1.0 (quartile 1 = 0.8, quartile 3 = 1.2). Only 6 patients (6.1%) had unplanned readmissions compared to the predicted 34%, p <0.0001. The average increase in distance walked was 52 m (18.4%), and the median increase in Duke Activity Status Index was 9.95 points (100%), p values <0.0001. New York Heart Association and Canadian Cardiovascular Society classes improved in 61% and 60% of the patients, respectively. In conclusion, patients with HF who received education and EECP within 90 days of discharge had significantly lower readmission rates than predicted, and improved functional status, walk distance, and symptoms.

「體外反搏治療對缺血性心肌毛病患者因心臟衰竭而 再入院 的影響」

心臟衰竭(HF)影響著數百萬美國人,並因需要重新住院而造成經濟負擔。因此,醫療系統和患者都在尋求減少 再入院 的方法。我們評估了通過教育計劃結合體外反搏(EECP)來減少後急性護理HF患者 再入院 的潛力。我們研究了99名HF患者,他們在90天內從醫院出院後被轉介到EECP中心接受心臟衰竭教育和EECP治療。我們比較了觀察到的和預測的90天 再入院 率,並檢查了EECP之前和之後的6分鐘步行測試、Duke活動狀態指數、紐約心臟協會分級和加拿大心血管學會分級的結果。患者在EECP治療時的平均增壓壓力為280毫米汞柱,並在第一次治療時就達到了。增壓比率在0.4至1.9之間變化,中位數為1.0。只有6名患者(6.1%)出現了非計劃 再入院 ,而預測的 再入院 率為34%。步行距離的平均增加為52米,Duke活動狀態指數的中位數增加了9.95分。紐約心臟協會和加拿大心血管學會的分級分別在61%和60%的患者中改善。結論是,在出院後的90天內接受教育和EECP治療的HF患者的 再入院 率顯著低於預測值,並且改善了功能狀態、步行距離和症狀。