目前预防心力衰竭再入院和失代偿疾病的方法。

IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Minerva cardiology and angiology Pub Date : 2024-10-01 Epub Date: 2023-07-05 DOI:10.23736/S2724-5683.23.06284-1
Matthew Mace, Niklas Lidströmer
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引用次数: 0

摘要

心力衰竭是一种资源密集型疾病,通常需要多学科、多方式的治疗,因此治疗费用昂贵。值得注意的是,入院治疗占心衰治疗费用的 80% 以上。在过去二十年里,医疗保健系统开发了远程跟踪病人的新方法,以防止他们再次入院。然而,尽管做出了这些努力,入院人数仍在增加。许多成功的减少再入院计划都将教育和自我保健放在首位,以提高患者对自身疾病的认识,促进生活方式的持久改变。虽然社会经济因素会影响成功与否,但如果强调坚持用药和以指南为指导的医疗治疗,干预措施往往会取得成效。监测心内压可提高资源分配效率,在门诊和远程环境中,监测心内压可显著降低再入院率,提高生活质量。几项以远程监测设备为重点的研究数据有力地表明,利用生理生物标志物了解充血情况是一种有效的管理策略。由于大多数心力衰竭病例都是在急性住院期间首次出现,因此立即获取心内压来进行治疗和决策,可以大大改善管理。然而,要想以低成本实现这一目标,并减少对稀缺的专科护理资源的依赖,还需要解决一个显著的技术差距。当代证据确凿表明,直接血流动力学是心力衰竭中临床效用最高的生命体征。因此,未来利用非侵入性方法可靠地获得这些信息的能力将是一项改变模式的技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current approaches to preventing heart failure readmissions and decompensated disease.

Heart failure is a resource-intensive condition to manage and typically involves a multi-disciplinary and multi-modality approach leading to an expensive treatment paradigm. It is worth noting that hospital admissions constitute over 80% of heart failure management costs. In the past two decades, healthcare systems have developed new ways of following patients remotely to prevent them from being readmitted to the hospital. However, despite these efforts, hospital admissions have still increased. Many successful readmission reduction programs prioritize education and self-care to increase patients' awareness of their disease and promote lasting lifestyle changes. While socioeconomic factors impact success, interventions tend to be effective when medication adherence and guideline-directed medical therapy are emphasized. Monitoring intracardiac pressure can improve resource allocation efficiency and has demonstrated significant reductions in readmissions with improved quality of life in outpatient and remote settings. Data from several studies focused on remote monitoring devices strongly suggest that understanding congestion using physiological biomarkers is an effective management strategy. Since most cases of heart failure are first presented in acute hospitalization settings, immediate access to intracardiac pressure for treatment and decision-making purposes could result in substantial management improvements. However, a notable technology gap needs to be addressed to enable this at a low cost with less reliability on scarce specialist care resources. Contemporary evidence is conclusive that direct hemodynamic are the vital signs in heart failure with the highest clinical utility. Therefore, future ability to obtain these insights reliably using non-invasive methods will be a paradigm-changing technology.

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来源期刊
Minerva cardiology and angiology
Minerva cardiology and angiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
18.80%
发文量
118
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