Barnett Adrian Gerard, Stewart Ian, Beevers Andrea, Fraser John F, Platts David
Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Queensland Health, The Prince Charles Hospital, Brisbane, Queensland, Australia.
BMJ Open. 2017 Oct 8;7(10):e017592. doi: 10.1136/bmjopen-2017-017592.
To examine whether providing thermal clothing improved the health of patients with heart failure during winter.
Parallel group randomised controlled trial.
Large public hospital in Brisbane during winter 2016.
91 patients with systolic or diastolic heart failure who were over 50 years old.
47 patients were randomised to receive thermal clothes (socks, top and hat) and 44 received usual care. Patients could not be blinded to their randomised group. All patients' data were available for the primary outcome which was collected blind to randomised group.
The primary outcome was the mean number of days in hospital during winter. Secondary outcomes included quality of life and sleep, and blood tests were collected for cardiovascular risk factors. Participants completed clothing diaries in midwinter which were used to estimate their overall clothing insulation using the 'clo'. Monitors inside the participants' homes recorded indoor temperatures throughout winter.
The mean number of days in hospital during winter was 4.2 in the usual care group and 3.0 in the thermal clothing group (mean difference -1.2 days, 95% CI -4.8 to 2.5 days). Most participants (85%) in the thermal clothing group reported using the thermals. There was an increase in overall clothing insulation at night in the thermal clothing group (mean difference 0.13 clo, 95% CI 0.03 to 0.23). Most participants in both groups did not wear sufficient clothing (defined as a clo below 1) and regularly experienced indoor temperatures below 18°C during midwinter.
There was no clear statistical improvement in health in the thermal clothing group. Efforts to improve health during winter may need to focus on passive interventions such as home insulation rather than interventions that target behaviour change.
ACTRN12615001023549; Results.
研究提供保暖衣物是否能改善心力衰竭患者冬季的健康状况。
平行组随机对照试验。
2016年冬季布里斯班的一家大型公立医院。
91名年龄超过50岁的收缩性或舒张性心力衰竭患者。
47名患者被随机分配接受保暖衣物（袜子、上衣和帽子），44名患者接受常规护理。患者无法对其随机分组情况不知情。所有患者的数据均可用于主要结局，该结局是在对随机分组不知情的情况下收集的。
主要结局是冬季住院天数的平均值。次要结局包括生活质量和睡眠，并且采集血液样本检测心血管危险因素。参与者在冬季中期完成衣物日记，用于使用“克罗”（clo）来估计其整体衣物隔热值。参与者家中的监测器记录整个冬季的室内温度。
常规护理组冬季住院天数的平均值为4.2天，保暖衣物组为3.0天（平均差值为 -1.2天，95%置信区间为 -4.8至2.5天）。保暖衣物组的大多数参与者（85%）报告使用了保暖衣物。保暖衣物组夜间的整体衣物隔热值有所增加（平均差值为0.13 clo，95%置信区间为0.03至0.23）。两组中的大多数参与者都没有穿足够的衣物（定义为克罗值低于1），并且在冬季中期经常经历室内温度低于18°C的情况。
保暖衣物组的健康状况在统计学上没有明显改善。在冬季改善健康状况的努力可能需要侧重于被动干预措施，如家庭隔热，而不是针对行为改变的干预措施。
ACTRN12615001023549；结果。
