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六分钟步行试验对峰值摄氧量和代谢当量的解释:一项预测心力衰竭患者再入院的前瞻性观察研究。

Peak oxygen uptake and metabolic equivalents explained by six-minute walk test: A prospective observational study in predicting heart failure patient readmission.

作者信息

Amir Muzakkir, Kabo Peter, Mappangara Idar, Djafar Zaenab, Zainuddin Andi Alfian, Warliani Melda, Mustafa Asni

机构信息

Department of Cardiology and Vascular Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

Department of Public Health Sciences, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

出版信息

Ann Med Surg (Lond). 2022 Apr 20;77:103652. doi: 10.1016/j.amsu.2022.103652. eCollection 2022 May.

Abstract

BACKGROUND

Current statistics indicate that the overall cost of heart disease exceeds IDR 6.67 trillion per year. This growing concern has led researches on heart failure patient readmission in developing countries, and opened discussions on tactics to suppress hospital readmission rates. This study assesses the potential of VO2max and METs obtained from the 6-min walk test in predicting heart failure patient readmission.

METHODS

This seven-month prospective cohort study recruited patients with heart failure which then underwent the 6-min walk test before discharged. Walking distance, estimated VO2 max, and METs were calculated and recorded. Patients were then followed-up for 3 months to track readmissions under the same diagnosis during the research period. The correlation between VO2max and METs with patient readmission was assessed.

RESULTS

A total of 93 samples were included in this study. The results demonstrated that VO2max and METs correlate with incidence of heart failure readmission ≤30 days post discharge, with VO2max showing a moderate ability to predict patient readmissions with a cut-off of 14.5 mL/kgBW/minute (C = 0.750, p < 0.001), while METs showed a weak ability to predict readmissions with a cut-off of 3.8 (C = 0.743, p < 0.001).

CONCLUSIONS

VO2 max and METs values acquired from 6MWT examination correlates with heart failure patient readmission ≤30 days. This knowledge can be used to prevent increased readmission rates, therefore hoping that it will be able to reduce the burden of treatment costs on heart failure patients.

摘要

背景

当前统计数据表明,心脏病的总体成本每年超过6.67万亿印尼盾。这种日益增长的担忧促使发展中国家对心力衰竭患者再入院情况展开研究,并开启了关于抑制医院再入院率策略的讨论。本研究评估了从6分钟步行试验中获得的最大摄氧量(VO2max)和代谢当量(METs)在预测心力衰竭患者再入院方面的潜力。

方法

这项为期七个月的前瞻性队列研究招募了心力衰竭患者,这些患者在出院前接受了6分钟步行试验。计算并记录步行距离、估计的最大摄氧量和代谢当量。然后对患者进行3个月的随访,以追踪研究期间相同诊断下的再入院情况。评估了最大摄氧量和代谢当量与患者再入院之间的相关性。

结果

本研究共纳入93个样本。结果表明,最大摄氧量和代谢当量与出院后≤30天的心力衰竭再入院发生率相关,最大摄氧量在截断值为14.5毫升/千克体重/分钟时显示出中等的预测患者再入院的能力(C = 0.750,p < 0.001),而代谢当量在截断值为3.8时显示出较弱的预测再入院的能力(C = 0.743,p < 0.001)。

结论

从6分钟步行试验检查中获得的最大摄氧量和代谢当量值与出院后≤30天的心力衰竭患者再入院相关。这一知识可用于预防再入院率的增加,因此希望能够减轻心力衰竭患者的治疗费用负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6992/9142551/c4a0323fd59a/gr1.jpg

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