Kawamura Takumi, Kitagaki Kazufumi, Takeuchi Miho, Arishima Kaori, Katou Tsuyoshi, Watanabe Keisuke
Department of Rehabilitation, Shinbeppu Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Beppu, JPN.
Faculty of Rehabilitation, Shijonawate Gakuen University, Daitō, JPN.
Cureus. 2025 Jul 30;17(7):e89080. doi: 10.7759/cureus.89080. eCollection 2025 Jul.
Background Patients with heart failure (HF) often face the need to maintain stable symptoms after discharge. Self-care management, including symptom monitoring, is recommended; however, because of factors such as population aging, these self-care behaviors are difficult to maintain for some patients, and the re-hospitalization rate remains high in Japanese registries. Objective In this retrospective cohort study, we aimed to verify whether the use of a self-care management tool among hospitalized patients with HF in a regional city hospital contributes to the reduction of cardiovascular events within a period of six months. Methods We retrospectively analyzed 117 patients hospitalized and treated for HF in Japan between December 2020 and November 2022. Patients admitted by November 2021 were assigned to the non-intervention group, while those admitted after this date and eligible to use the tool were assigned to the intervention group. The incidence of readmission owing to cardiovascular events within six months after discharge was analyzed. Results The Gray test, with unexpected readmissions and deaths due to causes other than cardiovascular events as competing risks, indicated that the intervention of using the self-care management tool reduced cardiovascular events (p=0.045). Even after adjusting for the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) score, the logarithm of B-type natriuretic peptide, and the use of sodium-glucose cotransporter 2 inhibitors, the effect of intervention with the self-care management tool remained significant (hazard ratio: 0.33; 95% confidence interval: 0.15-0.74, p<0.01). Conclusions The use of a self-care management tool for patients with HF was associated with a reduction in cardiovascular events.
背景 心力衰竭（HF）患者出院后往往需要维持症状稳定。推荐进行自我护理管理，包括症状监测；然而，由于人口老龄化等因素，一些患者难以维持这些自我护理行为，日本登记数据显示再住院率仍然很高。目的 在这项回顾性队列研究中，我们旨在验证在地区城市医院住院的HF患者中使用自我护理管理工具是否有助于在六个月内减少心血管事件。方法 我们回顾性分析了2020年12月至2022年11月期间在日本住院并接受HF治疗的117例患者。2021年11月前入院的患者被分配到非干预组，而在此日期之后入院且有资格使用该工具的患者被分配到干预组。分析出院后六个月内心血管事件导致的再入院发生率。结果 以心血管事件以外原因导致的意外再入院和死亡作为竞争风险的Gray检验表明，使用自我护理管理工具的干预减少了心血管事件（p = 0.045）。即使在调整慢性心力衰竭荟萃分析全球组（MAGGIC）评分、B型利钠肽对数和钠-葡萄糖协同转运蛋白2抑制剂的使用情况后，自我护理管理工具干预的效果仍然显著（风险比：0.33；95%置信区间：0.15 - 0.74，p < 0.01）。结论 对HF患者使用自我护理管理工具与心血管事件减少相关。
