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心力衰竭患者的再入院率及相关因素:黎巴嫩的一项研究。

Readmission rates and related factors in heart failure patients: A study in Lebanon.

作者信息

Deeka Hiba, Skouri Hadi, Noureddine Samar

出版信息

Collegian. 2016;23(1):61-8. doi: 10.1016/j.colegn.2014.11.001.

Abstract

BACKGROUND

Heart failure is the leading cause of hospitalization among older adults in the United States and other developed countries. Readmission rates of heart failure patients is one of the key outcome performance measures used in evaluating the quality of care of these patients. In Lebanon, there are no published data on readmission of heart failure patients. The aim of the study was to examine the readmission rates of heart failure patients within 30, 60 and 90 days of discharge from the hospital, and factors associated with readmission.

METHODS

The medical records of all 187 patients admitted with heart failure to Rafic Hariri University Hospital in Beirut between January 1, 2010 and December 31, 2010 were reviewed. Data on demographic and relevant clinical variables were retrieved.

RESULTS

Readmission rates were 15%, 22.2%, and 27.8% at 30, 60 and 90 days following discharge, respectively. The majority of readmissions (73.61%) were due to heart failure exacerbations. Significant predictors of readmission were: history of diabetes mellitus, coronary artery disease, length of stay at the index admission and gamma glutamyl transpeptidase levels. Management of the patients did not always conform to the evidence based guidelines.

CONCLUSION

The findings suggest the need for better adherence to clinical guidelines in caring for heart failure patients and improved documentation of discharge instructions.

摘要

背景

在美国和其他发达国家,心力衰竭是老年人住院的主要原因。心力衰竭患者的再入院率是评估这些患者护理质量的关键指标之一。在黎巴嫩,尚无关于心力衰竭患者再入院情况的公开数据。本研究的目的是调查心力衰竭患者出院后30天、60天和90天内的再入院率以及与再入院相关的因素。

方法

回顾了2010年1月1日至2010年12月31日期间在贝鲁特拉菲克·哈里里大学医院收治的187例心力衰竭患者的病历。收集了人口统计学和相关临床变量的数据。

结果

出院后30天、60天和90天的再入院率分别为15%、22.2%和27.8%。大多数再入院(73.61%)是由于心力衰竭加重。再入院的显著预测因素包括:糖尿病史、冠状动脉疾病、首次入院的住院时间以及γ-谷氨酰转肽酶水平。对患者的管理并非总是符合循证指南要求。

结论

研究结果表明,在护理心力衰竭患者时需要更好地遵循临床指南,并改进出院指导的记录。

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