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住院老年心力衰竭患者日常生活活动与 90 天内再入院的关系。

Relationship between Activities of Daily Living and Readmission within 90 Days in Hospitalized Elderly Patients with Heart Failure.

机构信息

Department of Physical Therapy, Kokura Rehabilitation College, 2-2-10 Kuzuharahigashi, Kokuraminami, Kitakyushu 800-0206, Japan.

Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma, Kobe 654-0142, Japan.

出版信息

Biomed Res Int. 2017;2017:7420738. doi: 10.1155/2017/7420738. Epub 2017 Oct 22.

Abstract

AIMS

To examine the relationship between activities of daily living (ADL) and readmission within 90 days and assess the cutoff value of ADL to predict readmission in hospitalized elderly patients with heart failure (HF).

METHODS

This cohort study comprised 589 consecutive patients with HF aged ≥65 years, who underwent cardiac rehabilitation from May 2012 to May 2016 and were discharged home. We investigated patients' characteristics, basic attributes, and ADL (motor and cognitive Functional Independence Measure [FIM]). We analyzed the data using the unpaired test, test, Cox proportional hazard model, receiver operating characteristic (ROC) curve, and Kaplan-Meier method.

RESULTS

Of 589 patients, 113 met the criteria, and they were divided into the nonreadmission ( = 90) and readmission groups ( = 23). Age, body mass index, New York Heart Association class, hemoglobin level, and motor FIM score were significantly different between the two groups ( < 0.05). The body mass index (hazard ratio [HR]: 0.87; < 0.05) and motor FIM score (HR: 0.94; < 0.01) remained statistically significant. The cutoff value for the motor FIM score determined by ROC curve analysis was 74.5 points (area under the curve = 0.78; < 0.001).

CONCLUSION

The motor FIM score in elderly patients with HF was an independent predictor of rehospitalization within 90 days.

摘要

目的

研究日常生活活动(ADL)与 90 天内再入院之间的关系,并评估 ADL 的截断值以预测住院老年心力衰竭(HF)患者的再入院。

方法

这项队列研究纳入了 589 名年龄≥65 岁、接受心脏康复治疗且出院回家的 HF 连续患者。我们调查了患者的特征、基本属性和 ADL(运动和认知功能独立性测量[FIM])。使用独立样本 t 检验、 检验、Cox 比例风险模型、受试者工作特征(ROC)曲线和 Kaplan-Meier 方法分析数据。

结果

在 589 名患者中,有 113 名符合标准,他们被分为未再入院组(n=90)和再入院组(n=23)。两组间年龄、体重指数、纽约心脏协会分级、血红蛋白水平和运动 FIM 评分差异有统计学意义(P<0.05)。体重指数(风险比[HR]:0.87;P<0.05)和运动 FIM 评分(HR:0.94;P<0.01)仍有统计学意义。ROC 曲线分析确定的运动 FIM 评分截断值为 74.5 分(曲线下面积=0.78;P<0.001)。

结论

HF 老年患者的运动 FIM 评分是 90 天内再入院的独立预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab3d/5671682/96ff00ea804d/BMRI2017-7420738.001.jpg

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