Assaad Mahmoud, Sarsam Sinan, Naqvi Amir, Zughaib Marcel
Division of Cardiology, Providence-Providence Park Hospitals, Southfield, USA.
JRSM Cardiovasc Dis. 2019 Feb 24;8:2048004019833290. doi: 10.1177/2048004019833290. eCollection 2019 Jan-Dec.
Hospital readmission for congestive heart failure remains one of the most important economic burdens on healthcare cost. The implantation of a wireless pressure monitoring device (CardioMEMS®) had led to nearly 40% reduction in readmission rates in the landmark CHAMPION trial. We aim to study the effectiveness of this wireless device in reducing heart failure admissions in a real-world setting.
This is a retrospective chart review of patients with recurrent admissions for heart failure implanted with the wireless pressure monitoring system (CardioMEMS®) at our institution. We studied the total number of all-cause hospital admissions as well as heart failure-related admissions pre- and post-implantation.
A total of 27 patients were followed for 6-18 months. The total number of all-cause hospital admissions prior to device implantation was 61 admissions for all study patients, while the total number for the post-implantation period was 19, correlating with 2.26 + 1.06 admissions/person-year prior to device implantation versus 0.70 + 0.95 admissions/person-year post-implantation (p-value < 0.001). For heart failure-related admissions, the total number prior to device implantation was 46 compared to 9 admissions post device implantations, correlating with 1.70 + 1.07 admissions/person-years pre-implantation versus 0.33 + 0.62 admissions/person-years post-implantation (p-value < 0.001). This translates to 80.4% and 68.9% reduction in heart failure and all-cause admissions, respectively.
In a real-world setting, the implantation of a wireless heart failure monitoring system in patients with heart failure and class III symptoms has resulted in 80.4% reduction in heart failure admissions and 69% reduction in all-cause admissions.
充血性心力衰竭患者的医院再入院仍是医疗成本最重要的经济负担之一。在具有里程碑意义的CHAMPION试验中,植入无线压力监测设备(CardioMEMS®)使再入院率降低了近40%。我们旨在研究这种无线设备在现实环境中降低心力衰竭入院率的有效性。
这是一项对在我们机构植入无线压力监测系统(CardioMEMS®)的复发性心力衰竭入院患者的回顾性图表审查。我们研究了植入前后全因住院次数以及与心力衰竭相关的住院次数。
共对27例患者进行了6至18个月的随访。所有研究患者在设备植入前全因住院总次数为61次,而植入后期间的总次数为19次,与设备植入前每人每年2.26 + 1.06次住院相比,植入后为每人每年0.70 + 0.95次住院(p值<0.001)。对于与心力衰竭相关的住院,设备植入前总数为46次,而设备植入后为9次,与植入前每人每年1.70 + 1.07次住院相比,植入后为每人每年0.33 + 0.62次住院(p值<0.001)。这分别转化为心力衰竭入院率和全因入院率降低了80.4%和68.9%。
在现实环境中,对有心力衰竭且有III级症状的患者植入无线心力衰竭监测系统,已使心力衰竭入院率降低了80.4%,全因入院率降低了69%。