Impact of Radar Chart-Based Information Sharing in a Multidisciplinary Team on In-Hospital Outcomes and Prognosis in Older Patients With Heart Failure.

Circulation Reports Pub Date : 2023-06-20 eCollection Date: 2023-07-10 DOI:10.1253/circrep.CR-23-0049
Satoshi Katano, Toshiyuki Yano, Ryo Numazawa, Ryohei Nagaoka, Kotaro Yamano, Yusuke Fujisawa, Suguru Honma, Ayako Watanabe, Katsuhiko Ohori, Hidemichi Kouzu, Takefumi Fujito, Tomoyuki Ishigo, Hayato Kunihara, Hiroya Fujisaki, Masaki Katayose, Akiyoshi Hashimoto, Masato Furuhashi
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Abstract

Background: A multidisciplinary team (MDT) approach is crucial for managing older patients with heart failure (HF). We investigated the impact on clinical outcomes of implementation of a conference sheet (CS) with an 8-component radar chart for visualizing and sharing patient information. Methods and Results: We enrolled 395 older inpatients with HF (median age 79 years [interquartile range 72-85 years]; 47% women) and divided them into 2 groups according to CS implementation: a non-CS group (before CS implementation; n=145) and a CS group (after CS implementation; n=250). The clinical characteristics of patients in the CS group were assessed using 8 scales (physical function, functional status, comorbidities, nutritional status, medication adherence, cognitive function, HF knowledge level, and home care level). In-hospital outcomes (Short Physical Performance Battery, Barthel Index score, length of hospital stay, and hospital transfer rate) were significantly better in the CS than non-CS group. During the follow-up period, 112 patients experienced composite events (all-cause death or admission for HF). Inverse probabilities of treatment-weighted Cox proportional hazard analyses demonstrated a 39% reduction in risk of composite events in the CS group (adjusted hazard ratio 0.65; 95% confidence interval 0.43-0.97). Conclusions: Radar chart-based information sharing among MDT members is associated with superior in-hospital clinical outcomes and a favorable prognosis.

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多学科团队基于雷达病历的信息共享对老年心力衰竭患者院内预后的影响
背景:多学科团队(MDT)方法对于管理老年心力衰竭(HF)患者至关重要。我们研究了实施会议单(CS)对临床结果的影响,该会议单由 8 个部分组成,雷达图用于可视化和共享患者信息。方法和结果:我们招募了 395 名老年心房颤动住院患者(中位年龄 79 岁[四分位数范围 72-85 岁];47% 为女性),并根据 CS 实施情况将其分为两组:非 CS 组(CS 实施前;人数=145)和 CS 组(CS 实施后;人数=250)。采用 8 个量表(身体功能、功能状态、合并症、营养状况、用药依从性、认知功能、高血压知识水平和家庭护理水平)评估 CS 组患者的临床特征。CS 组的院内疗效(短期体能测试、Barthel 指数评分、住院时间和转院率)明显优于非 CS 组。在随访期间,112 名患者发生了复合事件(全因死亡或因高血压入院)。治疗加权 Cox 比例危险分析的逆概率显示,CS 组发生复合事件的风险降低了 39%(调整后危险比为 0.65;95% 置信区间为 0.43-0.97)。结论MDT成员之间基于雷达图的信息共享与良好的院内临床结果和预后有关。
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