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Factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: A systematic review
BACKGROUND: Heart failure has high mortality and is linked to substantial burden for patients, carers and health care systems. Patients with chronic heart failure frequently experience recurrent hospitalisations peaking at the end of life, but most prefer to avoid hospital. The drivers of hospitalis...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749018/ https://www.ncbi.nlm.nih.gov/pubmed/36172637 http://dx.doi.org/10.1177/02692163221123422 |
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author | Zehnder, Aina R Pedrosa Carrasco, Anna J Etkind, Simon N |
author_facet | Zehnder, Aina R Pedrosa Carrasco, Anna J Etkind, Simon N |
author_sort | Zehnder, Aina R |
collection | PubMed |
description | BACKGROUND: Heart failure has high mortality and is linked to substantial burden for patients, carers and health care systems. Patients with chronic heart failure frequently experience recurrent hospitalisations peaking at the end of life, but most prefer to avoid hospital. The drivers of hospitalisations are not well understood. AIM: We aimed to synthesise the evidence on factors associated with all-cause and heart failure hospitalisations of patients with advanced chronic heart failure. DESIGN: Systematic review of studies quantitatively evaluating factors associated with all-cause or heart failure hospitalisations in adult patients with advanced chronic heart failure. DATA SOURCES: Five electronic databases were searched from inception to September 2020. Additionally, searches for grey literature, citation searching and hand-searching were performed. We assessed the quality of individual studies using the QualSyst tool. Strength of evidence was determined weighing number, quality and consistency of studies. Findings are reported narratively as pooling was not deemed feasible. RESULTS: In 54 articles, 68 individual, illness-level, service-level and environmental factors were identified. We found high/moderate strength evidence for specialist palliative or hospice care being associated with reduced risk of all-cause and heart failure hospitalisations, respectively. Based on high strength evidence, we further identified black/non-white ethnicity as a risk factor for all-cause hospitalisations. CONCLUSION: Efforts to integrate hospice and specialist palliative services into care may reduce avoidable hospitalisations in advanced heart failure. Inequalities in end-of-life care in terms of race/ethnicity should be addressed. Further research should investigate the causality of the relationships identified here. |
format | Online Article Text |
id | pubmed-9749018 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-97490182022-12-15 Factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: A systematic review Zehnder, Aina R Pedrosa Carrasco, Anna J Etkind, Simon N Palliat Med Review Articles BACKGROUND: Heart failure has high mortality and is linked to substantial burden for patients, carers and health care systems. Patients with chronic heart failure frequently experience recurrent hospitalisations peaking at the end of life, but most prefer to avoid hospital. The drivers of hospitalisations are not well understood. AIM: We aimed to synthesise the evidence on factors associated with all-cause and heart failure hospitalisations of patients with advanced chronic heart failure. DESIGN: Systematic review of studies quantitatively evaluating factors associated with all-cause or heart failure hospitalisations in adult patients with advanced chronic heart failure. DATA SOURCES: Five electronic databases were searched from inception to September 2020. Additionally, searches for grey literature, citation searching and hand-searching were performed. We assessed the quality of individual studies using the QualSyst tool. Strength of evidence was determined weighing number, quality and consistency of studies. Findings are reported narratively as pooling was not deemed feasible. RESULTS: In 54 articles, 68 individual, illness-level, service-level and environmental factors were identified. We found high/moderate strength evidence for specialist palliative or hospice care being associated with reduced risk of all-cause and heart failure hospitalisations, respectively. Based on high strength evidence, we further identified black/non-white ethnicity as a risk factor for all-cause hospitalisations. CONCLUSION: Efforts to integrate hospice and specialist palliative services into care may reduce avoidable hospitalisations in advanced heart failure. Inequalities in end-of-life care in terms of race/ethnicity should be addressed. Further research should investigate the causality of the relationships identified here. SAGE Publications 2022-09-28 2022-12 /pmc/articles/PMC9749018/ /pubmed/36172637 http://dx.doi.org/10.1177/02692163221123422 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Review Articles Zehnder, Aina R Pedrosa Carrasco, Anna J Etkind, Simon N Factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: A systematic review |
title | Factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: A systematic review |
title_full | Factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: A systematic review |
title_fullStr | Factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: A systematic review |
title_full_unstemmed | Factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: A systematic review |
title_short | Factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: A systematic review |
title_sort | factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: a systematic review |
topic | Review Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749018/ https://www.ncbi.nlm.nih.gov/pubmed/36172637 http://dx.doi.org/10.1177/02692163221123422 |
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