Departamento de Medicina Interna , Hospital Pedro Hispano , Matosinhos - Portugal.
Departamento de Cardiologia , Centro Hospitalar e Universitário de Coimbra , Coimbra - Portugal.
Arq Bras Cardiol. 2022 Mar;118(3):599-604. doi: 10.36660/abc.20201264.
The natural history of heart failure is a progressive decline and recurrent hospital admissions. New strategies to timely detect decompensations are needed. The use of telemonitoring in heart failure is inconsistent.
This study aimed to evaluate the impact of this telemonitoring program (TMP) in hospitalizations and emergency department admissions.
This is a retrospective observational study, that analyzed data of all the patients who enrolled in the TMP program from January 2018 to December 2019. Demographic, clinical, and TMP-related data were collected. The number of hospitalizations and emergency department admissions from the year before and after enrollment were compared, using the Wilcoxon test. A two-sided p<0.05 was considered significant.
A total of 39 patients were enrolled, with a mean age of 62.1 ± 14 years and a male predominance (90%). The most common causes of heart failure were ischemic and dilated cardiomyopathy. The mean ejection fraction was 30% and the median time of disease duration was 84 months (IQR 33-144). Patients who were enrolled for less than one month were excluded, with a total of 34 patients analyzed. Patients were followed in the TMP for a median of 320 days. The number of emergency department admissions was reduced by 66% (p<0.001), and the number of hospitalizations for heart failure was reduced by 68% (p<0.001). The TMP had no impact on the number of hospitalizations for other causes.
This trial suggests that a TMP could reduce health service use in patients with heart failure.
心力衰竭的自然病程是逐渐恶化和反复住院。需要新的策略来及时发现失代偿。心力衰竭的远程监测使用并不一致。
本研究旨在评估该远程监测计划（TMP）对住院和急诊就诊的影响。
这是一项回顾性观察性研究，分析了 2018 年 1 月至 2019 年 12 月期间所有参加 TMP 计划的患者的数据。收集了人口统计学、临床和 TMP 相关数据。使用 Wilcoxon 检验比较了参加 TMP 前后一年的住院和急诊就诊次数。双侧 p<0.05 被认为具有统计学意义。
共纳入 39 例患者，平均年龄为 62.1±14 岁，男性居多（90%）。心力衰竭的最常见病因是缺血性和扩张型心肌病。平均射血分数为 30%，疾病持续时间中位数为 84 个月（IQR 33-144）。排除了参加 TMP 不足一个月的患者，共分析了 34 例患者。患者在 TMP 中平均随访 320 天。急诊就诊次数减少了 66%（p<0.001），心力衰竭住院次数减少了 68%（p<0.001）。TMP 对其他原因导致的住院次数没有影响。
本试验表明，TMP 可减少心力衰竭患者对卫生服务的使用。
