Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Division of Cardiology, Duke Clinical Research Institute, Durham, North Carolina, USA.
J Palliat Med. 2022 Feb;25(2):296-300. doi: 10.1089/jpm.2021.0220. Epub 2021 Dec 1.
Black patients have a higher incidence of heart failure (HF) and worse outcomes than white patients. Guidelines recommend palliative care for patients with advanced HF, but no studies have examined outcomes in a black patient cohort. This is a analysis of the Palliative Care in Heart Failure trial, which randomized patients to usual care plus a palliative care intervention (UC+PAL) or usual care (UC). Quality of life (QoL) was measured using Kansas City Cardiomyopathy Questionnaire (KCCQ) and Functional Assessment of Chronic Illness Therapy-Palliative Care scale (FACIT-Pal). Black patients represented 41% of the 148 patients. At six months, QoL improved more in UC+PAL than UC for both racial subgroups. The difference was greater for black than white patients (difference: KCCQ 10.8 vs. 2.5; FACIT-Pal: 14.8 vs. 3.9). However, the findings were not statistically significant. Larger studies are needed to assess the benefits of palliative care for black patients with HF. ClinicalTrials.gov Identifier: NCT01589601.
黑人患者心力衰竭(HF)的发病率高于白人患者,且预后更差。指南建议对晚期 HF 患者进行姑息治疗,但尚无研究在黑人患者队列中检查结局。这是对心力衰竭姑息治疗试验(Palliative Care in Heart Failure trial)的事后分析,该试验将患者随机分配至常规治疗加姑息治疗干预(UC+PAL)或常规治疗(UC)。使用堪萨斯城心肌病问卷(Kansas City Cardiomyopathy Questionnaire,KCCQ)和慢性疾病治疗-姑息治疗功能评估量表(Functional Assessment of Chronic Illness Therapy-Palliative Care scale,FACIT-Pal)评估生活质量(quality of life,QoL)。148 名患者中 41%为黑人。在 6 个月时,UC+PAL 组比 UC 组的两组种族亚组的 QoL 改善更多。黑人群体的改善程度大于白人群体(差异:KCCQ 为 10.8 分 vs. 2.5 分;FACIT-Pal 为 14.8 分 vs. 3.9 分)。然而,这些发现没有统计学意义。需要更大的研究来评估姑息治疗对 HF 黑人患者的益处。ClinicalTrials.gov 标识符:NCT01589601。