Impact of Oral Treatment on Physical Function in Older Patients Hospitalized for Heart Failure: A Randomized Clinical Trial.
Impact of Oral Treatment on Physical Function in Older Patients Hospitalized for Heart Failure: A Randomized Clinical Trial.
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口服治疗对心力衰竭住院老年患者身体机能的影响：一项随机临床试验。
DOI：
10.1371/journal.pone.0167933
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Shirai T
中科院分区：
文献类型：
--
作者：
Ueda K;Kasao M;Shimamura M;Haruta H;Nitta S;Kaneko M;Uemura Y;Morita H;Komuro I;Shirai T
虚弱是老年心力衰竭患者的特征，他们在住院期间会出现功能下降。目前，利尿剂的持续静脉输注被广泛用于住院心力衰竭患者的治疗。在这项前瞻性、随机、开放标签对照试验中，我们测试了早期从持续静脉输注治疗转向利尿剂口服治疗是否能防止因心力衰竭住院的患者功能下降。59名因心力衰竭住院的患者在入院48小时内被随机分为持续静脉输注组(n=30)和口服药物组(n=29)。主要结果是Barthel指数，这是一种普遍使用的量表，用于评估患者在日常生活活动中的功能状况，在10天时进行评估。次要结果包括使用计步器计算的每日步数和平均住院费用。口服药物组Barthel指数评分显著高于静脉组(78.1vs.59.6±34.2vs.59.6±34.2，P=0.029)。口服治疗组的每日步行次数显著高于静脉注射组(P<；0.001)，而随机组之间的平均住院费用相似。多变量分析显示，口服药物是第10天Barthel指数评分的显著独立预测因子，每天的步数与患者的功能结果显著相关。这项试验表明，在因心力衰竭住院的患者中，与持续的持续静脉输液相比，口服药物在住院期间增加了功能独立性，最可能是因为输液管道的释放使患者能够更灵活地行动。值得注意的是，这些有益的效果是在没有增加医院成本的情况下实现的。
Frailty is a characteristic of older patients with heart failure, who undergo functional decline during hospitalization. At present, continuous intravenous infusion of diuretics is widely used for the treatment of hospitalized patients with heart failure. In this prospective, randomized, open-label controlled trial, we tested whether an early switch from continuous intravenous infusion therapy to oral treatment with diuretics prevents functional decline in patients hospitalized for heart failure. A total of 59 patients hospitalized for heart failure were randomized to either continuous intravenous infusion (n = 30) or oral medication (n = 29) within 48 h of admission. The primary outcome was the Barthel index, a universally utilized scale to assess the functional status of patients in their activities of daily living, assessed at 10 days. Secondary outcomes included the number of daily steps counted using pedometers and average hospital costs. Barthel index scores were significantly higher in the oral medication group than in the intravenous group (78.1 ± 20.8 vs. 59.6 ± 34.2, P = 0.029). The number of daily steps was significantly higher in the oral treatment group relative to the intravenous group (P < 0.001), and the average hospital costs were similar between the randomized groups. Multivariate analysis revealed that oral medication was a significant independent predictor of Barthel index score at day 10, and the number of daily steps was significantly associated with the patient’s functional outcome. This trial showed that, in patients hospitalized for heart failure, oral medication increased functional independence during hospitalization compared with sustained continuous intravenous infusion, most likely because the release from the infusion line enabled the patients to be more mobile. Notably, these beneficial effects were achieved without increasing hospital costs.
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DOI：
10.1111/j.1532-5415.2012.04054.x
发表时间：
2012-08-01
影响因子：
6.3
作者：
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