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贫血在心力衰竭门诊患者中的患病率及其对再次入院和急诊就诊的影响。

Prevalence of anemia and its influence on hospital readmissions and emergency department visits in outpatients with heart failure.

作者信息

Son Youn-Jung, Kim Bo Hwan

机构信息

1 Red Cross College of Nursing, Chung-Ang University, Seoul, Korea.

2 College of Nursing, Gachon University, Incheon, Korea.

出版信息

Eur J Cardiovasc Nurs. 2017 Dec;16(8):687-695. doi: 10.1177/1474515117710154. Epub 2017 May 12.

Abstract

BACKGROUND

Anemia is a frequent comorbidity in patients with heart failure. However, the incidence of anemia in patients with heart failure varies widely, and there is limited evidence on the association between anemia and rehospitalization and on the health consequences of anemia in patients with heart failure.

AIMS

We aimed to identify the prevalence of anemia and its influence on hospital readmissions and emergency department visits in outpatients with heart failure.

METHODS

This cross-sectional study included 284 patients with heart failure diagnosed at outpatient cardiology clinics at a tertiary care university hospital in Cheonan, South Korea. We obtained socio-demographic and clinical information, including frequency of readmissions and emergency department visits, using face-to-face interviews and medical record reviews.

RESULTS

The prevalence of anemia, defined based on World Health Organization guidelines, was 39.1% among patients with heart failure. Anemia was significantly more prevalent among patients with one or more re-admissions or emergency department visits compared with patients with no history of hospital re-admissions or emergency department visits (42.7% vs. 13.9% ( p = 0.001) and 55.1% vs. 34% ( p = 0.002) respectively). Anemia increased the risk of hospital readmission (odds ratio =8.04, 95% confidence interval, 2.19-29.54) and emergency department visit (odds ratio=2.37, 95% confidence interval, 1.22-4.60) in patients with heart failure.

CONCLUSION

It is imperative that patients with heart failure presenting with anemia undergo appropriate nursing assessment and intervention. Future prospective studies targeting interventions to improve anemia are required to determine whether anemia influences readmission rates and emergency department visits.

摘要

背景

贫血是心力衰竭患者常见的合并症。然而,心力衰竭患者贫血的发生率差异很大,关于贫血与再住院之间的关联以及贫血对心力衰竭患者健康后果的证据有限。

目的

我们旨在确定贫血在心力衰竭门诊患者中的患病率及其对再次住院和急诊就诊的影响。

方法

这项横断面研究纳入了韩国天安一所三级护理大学医院门诊心脏病诊所诊断的284例心力衰竭患者。我们通过面对面访谈和病历审查获取了社会人口统计学和临床信息,包括再次住院和急诊就诊的频率。

结果

根据世界卫生组织指南定义,心力衰竭患者中贫血的患病率为39.1%。与无再次住院或急诊就诊史的患者相比,有一次或多次再次住院或急诊就诊的患者贫血明显更为普遍(分别为42.7%对13.9%(p = 0.001)和55.1%对34%(p = 0.002))。贫血增加了心力衰竭患者再次住院的风险(比值比 = 8.04,95%置信区间,2.19 - 29.54)和急诊就诊的风险(比值比 = 2.37,95%置信区间,1.22 - 4.60)。

结论

患有贫血的心力衰竭患者必须接受适当的护理评估和干预。未来需要针对改善贫血的干预措施进行前瞻性研究,以确定贫血是否会影响再入院率和急诊就诊率。

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