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Capability for self-care of patients with heart failure

Session Poster Session 1

Speaker Associate Professor Agnieszka Mlynarska

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure – Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : A Mlynarska (Katowice,PL), R Mlynarski (Katowice,PL), C Marcisz (Katowice,PL), KS Golba (Katowice,PL)

Authors:
A Mlynarska1 , R Mlynarski1 , C Marcisz1 , KS Golba1 , 1Medical University of Silesia - Katowice - Poland ,

Citation:

The lack of compliance with medical and other lifestyle recommendations is a serious problem in elderly patients who suffer from heart failure (HF) and have serious consequences for individual patients and their families as well as for the health care system. The aim of the study was to evaluate the influence of the level of the capability for self-care on the number of rehospitalizations in patients with HF.
METHODS: 180 pts. (aged 72.8±8.0 years; 29.4% W) diagnosed with HF were included in the study. The follow­ing inclusion criteria were used: the diagnosed with HF at least 6 months earlier and being more than 60 years of age. The mean follow-up time was 454.6±262.1 days. The treatment for HF was verified and the optimal therapy (pharmacological and/or device-based) was confirmed in all of the participants. Depending on the treatment that was being used, the patients were divided into three groups: Group I: HF being treated conservatively by pharmaco­logical treatment and lifestyle changes (treated conser­vatively), 51 patients (28.3%); Group II: HF being treated with the implantation of a cardioverter-defibrillator (ICD), 47 patients (26.1%); Group III: HF being treated with the implantation of a cardiac resynchronization system (CRT), 82 patients (45.6%). In all of the patients the Polish version of the nine-item European Heart Failure Self-care Behavior Scale (EHFScBS-9) was used – the more the points one gets, the worse the capability for self-care is. The data were analyzed statistically, and the values were treated as significant when p<0.05.  
RESULTS: The ROC curves for all groups are presented in the figure below. The EHFScBS-9, which has a cutoff value of >28 points, identified patients that had a significantly higher risk of rehospitalization for HF. The analysis of the impact of the capability for self-care on rehospitalization revealed that in the group of patients that were treated conservatively, the cutoff point was =30 points (P=0.1738), in the group of patients that were treated with ICD it was >32 points (P=0.0001) and in the group of patients that were treated with CRT it was >28 points (P=0.0394).
CONCLUSIONS: The level of the capability for self-care in patients with HF has been described as an additional risk factor for rehos­pitalization. The lower cutoff level for patients with implanted CRT seems to be clinically signifi­cant. It concerns the group of the most burdened patients, and despite the fact that it was the group that showed the best capability for self-care, it was the one that was most frequently rehospitalized.

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