Servicio de Neumología, Dirección Asistencial, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Area Sanitaria da Coruña e Cee, Sergas, Universidade da Coruña (UDC), As Xubias, 15006 A Coruña, Spain.
Servicio de Neumología, NeumoVigoI+i Research Group, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Hospital Álvaro Cunqueiro de Vigo, Sergas, Spain.
Arch Bronconeumol. 2022 Jun;58(6):474-481. doi: 10.1016/j.arbres.2020.05.030. Epub 2020 Jun 27.
Currently there is lack of data regarding the impact of a home telehealth program on readmissions and mortality rate after a COPD exacerbation-related hospitalization.
To demonstrate if a tele-monitoring system after a COPD exacerbation admission could have a favorable effect in 1-year readmissions and mortality in a real-world setting.
This is an observational study where we compared an intervention group of COPD patients treated after hospitalization that conveyed a telehealth program with a followance period of 1 year with a control group of patients evaluated during one year before the intervention began. A propensity-score analyses was developed to control for confounders. The main clinical outcome was 1-year all-cause mortality or COPD-related readmission.
The analysis comprised 351 telemonitoring patients and 495 patients in the control group. The intervention resulted in less mortality or readmission after 12 months (35.2% vs. 45.2%; hazard ratio [HR] 0.71 [95% CI=0.56-0.91]; p=0.007). This benefit was maintained after the propensity score analysis (HR=0.66 [95% CI=0.51-0.84]). This benefit, which was seen from the first month of the study and during its whole duration, is maintained when mortality (HR=0.54; 95% CI=[0.36-0.82]) or readmission (subdistribution hazard ratio [SHR] 0.66; 95% CI=[0.50-0.86]) are analyzed separately.
Telemonitoring after a severe COPD exacerbation is associated with less mortality or readmissions at 12 months in a real world clinical setting.
目前，关于家庭远程医疗计划对 COPD 加重相关住院后再入院率和死亡率的影响，数据有限。
展示 COPD 加重住院后使用远程监测系统是否能在真实环境中对 1 年内再入院和死亡率产生有利影响。
这是一项观察性研究，我们将接受远程健康计划治疗的 COPD 患者干预组与在干预开始前 1 年内接受评估的对照组进行比较。采用倾向评分分析来控制混杂因素。主要临床结局为 1 年全因死亡率或 COPD 相关再入院。
分析包括 351 名远程监测患者和 495 名对照组患者。干预组在 12 个月时死亡率或再入院率较低（35.2% vs. 45.2%；风险比[HR]0.71[95%CI=0.56-0.91]；p=0.007）。在进行倾向评分分析后，这一益处仍然存在（HR=0.66[95%CI=0.51-0.84]）。从研究的第一个月到整个研究期间，这种获益得以维持，当分别分析死亡率（HR=0.54[95%CI=0.36-0.82]）或再入院率（亚分布风险比[SHR]0.66[95%CI=0.50-0.86]）时，获益仍得以维持。
在真实临床环境中，严重 COPD 加重后进行远程监测与 12 个月时的死亡率或再入院率降低相关。
