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Vpliv obravnave v specializirani ambulanti na prognozo in kakovost življenja bolnikov s srčnim popuščanjem : [doktorsko delo]
Lainščak, Mitja
Background. Management in heart failure clinic (HFC) improves prognosis, quality of life and pharmacological treatment of heart failure patients. However, the influence of individual management ...components and patients knowledge to the outcome is still not well established. Aim. To evaluate the effect of management in the HFC compared to the usual care (UC) on hospitalisations, survival, quality of life, pharmacological treatment, and patients knowledge. Methods. In our prospective nonrandomised study we followed 50 patients (mean age 67 (12) years, 66% men) from HFC and 65 patients (mean age 71 (12) years, 65% men) from the UC group for at least one year. Hospitalizations, survival, pharmacological treatment, and patients knowledge were compared using Kaplan Meier curves, log-rank test, Cox hazard model, test X2, and Student t-test as appropriate. We validated our Patients knowledge questionnaire (Pearson coefficient, Cronbahh a, Student t-test, and Wilcoxon signed rank test) and compared the result between the groups (Studentt-test). Results. Patients from HFC had better survival (16% vs. 38%, p=0.008) and were less frequently hospitalised due to heart failure than patients form the UC group (34% vs. 55%, p=0.023). Only management in HFC independently predicted better survival (hazard ratio - HR 0.12, 95% CI 0.02-0.54), hospitalizations due to heart failure (HR 0.33, 95% CI 0.12-0.87) or the combined end point (HR 0.19, 95% CI 0.07-0.53). Independent predictors of prognosis among patients from HFC were poor patientćs knowledge (HR 3.92, 95% CI 1.39-11.03) and treatment with more than 50% of beta blockers target daily dose (HR 0.30, 95% CI 0.10-0.95). (Abstract truncated at 2000 characters)
Type of material - dissertation
; adult, serious
Publication and manufacture - V Ljubljani : [M. Lainščak], 2005
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