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在心力衰竭患者中进行姑息治疗干预后生活质量的种族差异:心力衰竭姑息治疗试验的见解。

Race Differences in Quality of Life following a Palliative Care Intervention in Patients with Advanced Heart Failure: Insights from the Palliative Care in Heart Failure Trial.

机构信息

Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.

Division of Cardiology, Duke Clinical Research Institute, Durham, North Carolina, USA.

出版信息

J Palliat Med. 2022 Feb;25(2):296-300. doi: 10.1089/jpm.2021.0220. Epub 2021 Dec 1.

Abstract

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.

摘要

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。

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