Effects of a nurse-led heart failure clinic on hospital readmission and mortality in Hong Kong

作     者：Ho Yu Cheng Sek Ying Chair Qun Wang Janet WH Sit Eliza ML Wong Siu Wai Tang 

作者机构：The Nethersole School of Nursing: Faculty of Medicine The Chinese University of Hong Kong Hong Kong China Cardiac Rehabilitation Centre Tung Wah Eastern Hospital Hong Kong China 

出 版 物：《Journal of Geriatric Cardiology》 (老年心脏病学杂志（英文版）)

年 卷 期：2016年第13卷第5期

页      面：415-419页

核心收录：

学科分类：090603[农学-临床兽医学] 1002[医学-临床医学] 09[农学] 0906[农学-兽医学] 

主　　题：心力衰竭 临床特征 死亡率 护士 香港 医院 老龄化社会 平均年龄 

摘      要：BACKGROUND:Heart failure (HF) is a physically and socially debilitating disease that carries the burden of hospital re-admission and mortality. As an aging society, Hong Kong urgently needs to find ways to reduce the hospital readmission of HF patients. This study evaluates the effects of a nurse-led HF clinic on the hospital readmission and mortality rates among older HF patients in Hong Kong.;METHODS:This study is a retrospective data analysis that compares HF patient in a nurse-led HF clinic in Hong Kong compared with HF patients who did not attend the clinic. The nurses of this clinic provide education on lifestyle modification and symptom monitoring, as well as titrate the medications and measure biochemical markers by following established protocols. This analysis used the socio-demographic and clinical data of HF patients who were aged ≥ 65 years old and stayed in the clinic over a six-month period.;RESULTS:The data of a total of 78 HF patients were included in this data analysis. The mean age of the patients was 77.38 ± 6.80 years. Approximately half of the HF patients were male (51.3%), almost half were smokers (46.2%), and the majority received ≤ six years of formal education. Most of the HF patients (87.2%) belonged to classes II and III of the New York Heart Association Functional Classification, with a mean ejection fraction of 47.15 ± 20.31 mL. The HF patients who attended the clinic (n = 38, 75.13 ± 5.89 years) were significantly younger than those who did not attend the clinic (n = 40, 79.53 ± 6.96 years) (P = 0.04), and had lower recorded blood pressure. No other statistically significant difference existed between the socio-demographic and clinical characteristics of the two groups. The HF patients who did not attend the nurse-led HF clinic demonstrated a significantly higher risk of hospital readmission [odd ratio (OR): 7.40; P 0.01] than those who attended after adjusting for the effect of age and blood pressure. In addition, HF patients who at