Lin Xiuzhen, Ji Ruxiang, Wang Xia, Xin Ruomei, Chen Qiongyan
Department of Hematology, Hainan Provincial People's Hospital (Hainan Hospital Affiliated to Hainan Medical College), Haikou, China.
Department of Urology, Dongfang People's Hospital, Dongfang, China.
J Thorac Dis. 2022 Apr;14(4):1164-1171. doi: 10.21037/jtd-22-102.
The purpose of this study was to explore the impact of transitional care interventions on the prognosis of patients with heart failure.
Literature on transitional care interventions in patients with heart failure were retrieved from PubMed, Medline, Embase, and CENTRAL databases. The literature retrieval date was October 12, 2021. The inclusion criteria were based on PICOS principles. A researcher independently extracted information from the literature included in the meta-analysis, including author, title, publication date, patient baseline information, intervention measures, and observation indicators. Two other researchers checked the extracted data. Cochrane bias risk assessment was used to evaluate the quality of the included study. The chi-square test was used for heterogeneity test. Egger test was used for publication bias test. Data were statistically analyzed using Cochrane software RevMan 5.3. The Chi-square test was used to assess heterogeneity. The odds ratio (OR) and 95% confidence interval (CI) were used to describe the count data statistically.
A total of 567 related articles were retrieved, and 18 studies were further screened for meta-analysis, 13 with low risk of overall bias, and 5 with high risk of overall bias. A total of 4,123 patients with heart failure were included, comprising 1,914 patients receiving transitional care interventions (46.42%) and 2,209 patients receiving routine care interventions (53.58%). The readmission rate of heart failure in patients receiving transitional care interventions was lower than that of patients receiving routine care interventions. There was heterogeneity among the literatures, and the source analysis of heterogeneity showed that the results were stable, and the random effect model was adopted without publication bias. The emergency visit rate of patients with heart failure receiving transitional care interventions was lower than that of patients receiving usual care interventions. There was no significant difference in mortality between patients receiving transitional care interventions and patients receiving usual care interventions.
Transitional care interventions can reduce the rate of patient readmission and emergency visits but have no significant impact on the mortality of patients. This study suggests the establishment of a transitional care intervention system for patients with heart failure.
本研究旨在探讨过渡性护理干预对心力衰竭患者预后的影响。
从PubMed、Medline、Embase和CENTRAL数据库中检索有关心力衰竭患者过渡性护理干预的文献。文献检索日期为2021年10月12日。纳入标准基于PICOS原则。一名研究人员独立从纳入荟萃分析的文献中提取信息，包括作者、标题、出版日期、患者基线信息、干预措施和观察指标。另外两名研究人员检查提取的数据。采用Cochrane偏倚风险评估来评价纳入研究的质量。采用卡方检验进行异质性检验。采用Egger检验进行发表偏倚检验。使用Cochrane软件RevMan 5.3对数据进行统计分析。采用卡方检验评估异质性。采用比值比（OR）和95%置信区间（CI）对计数资料进行统计学描述。
共检索到567篇相关文章，进一步筛选出18项研究进行荟萃分析，其中13项总体偏倚风险低，5项总体偏倚风险高。共纳入4123例心力衰竭患者，其中1914例接受过渡性护理干预（46.42%），2209例接受常规护理干预（53.58%）。接受过渡性护理干预的患者心力衰竭再入院率低于接受常规护理干预的患者。文献之间存在异质性，异质性来源分析显示结果稳定，采用随机效应模型且无发表偏倚。接受过渡性护理干预的心力衰竭患者急诊就诊率低于接受常规护理干预的患者。接受过渡性护理干预的患者与接受常规护理干预的患者死亡率无显著差异。
过渡性护理干预可降低患者再入院率和急诊就诊率，但对患者死亡率无显著影响。本研究建议为心力衰竭患者建立过渡性护理干预体系。
