早期电话随访对慢性心力衰竭出院患者30天再次住院率的影响

Relationship between early phone follow-up and 30-day readmission among hospitalized patients for chronic heart failure

目的探讨早期电话随访能否减少慢性心力衰竭出院患者的30 d再次住院率。方法 2012年6月至2013年6月期间在本院心内科住院确诊的慢性心力衰竭患者700例,随机分为早期电话随访组(出院1周内电话随访,250例),常规电话随访组(出院1周至1月内随访,260例),未随访组(出院后未随访,190例),观察30 d内3组患者因心力衰竭加重的再次住院率、再次住院死亡率及再次入院的危险因素。结果早期电话随访组30 d内再次住院比例(49例,19.6%)明显低于常规电话随访组(61例,23.4%)和未随访组(50例,26.3%)(P均<0.05);早期电话随访组30 d内再住院死亡比例(7例,2.8%)明显低于常规电话随访组(12例,4.6%)和未随访组(13例,6.8%)(P均<0.05)。再次住院的危险因素分析结果显示:利尿剂、β受体阻滞剂、地高辛应用不合理引起的再住院比例,早期电话随访组明显低于常规电话随访组,且明显低于未随访组;诱因为感染、心律失常及其他原因引起的再住院比例3组之间无统计学差异(P>0.05)。结论早期电话随访可能是降低慢性心力衰竭患者再住院率的一种有效方法。

Objective To examine the associations between outpatient follow-up within 7 days after discharge from a chronic heart failure hospitalization and readmission within 30 days. Methods A total of 700 hospitalized patients with chronic heart failure were divided into early phone follow-up group,routine phone follow-up group and no-follow-up group.The 30-day readmissions and rehospitalized mortality caused by worsening heart failure were observed and analyzed. Results The study population included 700 patients from the Center Hospital of Suizhou. 30-day readmissions of early phone follow-up group was 19. 6%,compared with 23. 4% and 26. 3% in routine phone follow-up group and no-follow-up group（ P〈0.05）.The rehospitalized mortality rate was 2.8% in early phone follow-up group,compared with 4.6% and 6.8% in routine phone follow-up group and no-follow-up group（ P〈0. 05）. The incidence rate of the incentives of readmissions,such as drug misuse was lowest in early phone follow-up group. Conclusions Among patients who were hospitalized for heart failure,early follow-up could reduce the risk of 30-day readmission and mortality.