复杂远程医疗支持对预防心力衰竭患者住院和死亡的比较效果：一项系统评价和荟萃分析

Comparative Effectiveness of Complex Telemedicine Support in Prevention of Hospitalizations and Mortality in Patients with Heart Failure: A Systematic Review and Meta-Analysis.

作者信息

Garanin Andrey, Rubanenko Anatoly, Trusov Yuriy, Rubanenko Olesya, Kolsanov Alexandr

机构信息

Scientific and Practical Center for Remote Medicine, FSBEI HE SamSMU MOH Russia, 443099 Samara, Russia.

Propaedeutic Therapy Department with the Course of Cardiology, FSBEI HE SamSMU MOH Russia, 443099 Samara, Russia.

出版信息

Life (Basel). 2024 Apr 15;14(4):507. doi: 10.3390/life14040507.

DOI:10.3390/life14040507

PMID:38672777

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11051353/

Abstract

UNLABELLED

Heart failure is one of the leading causes of hospitalizations and mortality all over the world. There are literature data about the favorable influence of telemedicine support on mortality and hospitalization rate in patients with heart failure, and thus, the results of different studies are controversial.

AIM

To estimate the effect of telemedicine support on hospitalization and mortality in patients with heart failure.

METHODS

The literature search was conducted in databases Google Scholar, MedLine, Clinical Trials, PubMed, Embase, and Crossref with the following key words: "heart failure", "telemedicine", "telemonitoring", "hospitalisation (hospitalization)", "mortality". We included studies that were conducted during the last 10 years. In total, we analyzed 1151 records. After screening, 14 randomized control trials were included in the final analysis.

RESULTS

The conducted meta-analysis showed that telemedicine support is accompanied by a decrease in heart failure-related hospitalizations (risk ratio (RR) 0.78 (95% confidence interval (CI) 0.68-0.89)) and a decrease in all-cause mortality (RR 0.84 (95% CI 0.75-0.94)). We did not find a significant association between telemedicine support and all-cause hospitalizations. We did not analyze heart failure-related mortality because of insufficient data.

CONCLUSION

Telemedicine support is accompanied by a decrease in heart failure-related hospitalizations and a decrease in all-cause mortality in patients with heart failure.

摘要

未标注

心力衰竭是全球住院和死亡的主要原因之一。有文献数据表明远程医疗支持对心力衰竭患者的死亡率和住院率有积极影响，然而，不同研究的结果存在争议。

目的

评估远程医疗支持对心力衰竭患者住院率和死亡率的影响。

方法

在谷歌学术、医学在线、临床试验、PubMed、Embase和Crossref数据库中进行文献检索，关键词如下：“心力衰竭”、“远程医疗”、“远程监测”、“住院”、“死亡率”。我们纳入了过去10年进行的研究。总共分析了1151条记录。筛选后，最终分析纳入了14项随机对照试验。

结果

进行的荟萃分析表明，远程医疗支持伴随着心力衰竭相关住院率的降低（风险比（RR）0.78（95%置信区间（CI）0.68 - 0.89））和全因死亡率的降低（RR 0.84（95% CI 0.75 - 0.94））。我们未发现远程医疗支持与全因住院之间存在显著关联。由于数据不足，我们未分析心力衰竭相关死亡率。