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Katano S, Yano T, Numazawa R, Nagaoka R, Yamano K, Fujisawa Y, Honma S, Watanabe A, Ohori K, Kouzu H, Fujito T, Ishigo T, Kunihara H, Fujisaki H, Katayose M, Hashimoto A, Furuhashi M. Impact of Radar Chart-Based Information Sharing in a Multidisciplinary Team on In-Hospital Outcomes and Prognosis in Older Patients With Heart Failure. Circ Rep 2023; 5:271-281. [PMID: 37431515 PMCID: PMC10329901 DOI: 10.1253/circrep.cr-23-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 05/18/2023] [Indexed: 07/12/2023] Open
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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Affiliation(s)
- Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital Sapporo Japan
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science Sapporo Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University Sapporo Japan
| | - Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital Sapporo Japan
| | - Kotaro Yamano
- Department of Rehabilitation, Teine Keijinkai Hospital Sapporo Japan
| | - Yusuke Fujisawa
- Department of Rehabilitation, Japanese Red Cross Asahikawa Hospital Asahikawa Japan
| | - Suguru Honma
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science Sapporo Japan
- Department of Rehabilitation, Sapporo Cardiovascular Hospital Sapporo Japan
| | - Ayako Watanabe
- Division of Nursing, Sapporo Medical University Hospital Sapporo Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
- Department of Cardiology, Hokkaido Cardiovascular Hospital Sapporo Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Takefumi Fujito
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
| | - Tomoyuki Ishigo
- Division of Hospital Pharmacy, Sapporo Medical University Hospital Sapporo Japan
| | - Hayato Kunihara
- Division of Rehabilitation, Sapporo Medical University Hospital Sapporo Japan
| | - Hiroya Fujisaki
- Division of Rehabilitation, Sapporo Medical University Hospital Sapporo Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science Sapporo Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
- Division of Health Care Administration and Management, Sapporo Medical University School of Medicine Sapporo Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine Sapporo Japan
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Koumo M, Goda A, Maki Y, Yokoyama K, Yamamoto T, Hosokawa T, Ishibashi R, Katsura J, Yanagibashi K. Clinical Items for Geriatric Patients with Post-Stroke at Discharge or Transfer after Rehabilitation Therapy in a Chronic-Phase Hospital: A Retrospective Pilot Study. Healthcare (Basel) 2022; 10:healthcare10081577. [PMID: 36011234 PMCID: PMC9408440 DOI: 10.3390/healthcare10081577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/13/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
Clinical factors related to destination after rehabilitation therapy for geriatric patients with post-stroke in chronic-phase hospitals have not been elucidated. This study analyzed the clinical characteristics of geriatric patients with post-stroke at discharge/transfer after rehabilitation therapy in a chronic-phase hospital. Fifty-three patients (20 men, 33 women; mean age 81.36 ± 8.14 years) were recruited (the period analyzed: October 2013−March 2020). Clinical data were statistically analyzed among patients discharged to homes or facilities for older adults or transferred to another hospital. In addition, we analyzed the clinical items at discharge and transfer after rehabilitation therapy using a decision tree analysis. Twelve patients were discharged, eighteen were discharged to facilities for older adults, and twenty-three were transferred to another hospital. There were significant differences in the modified Rankin Scale, admission dates, functional independence measure (FIM) score, and Barthel Index score in the three groups (p < 0.05). Patients with motor subtotal functional independence scores of ≥14 (chronologically improved ≥5) after rehabilitation therapy for <291 days were more likely to be discharged home. Patients in a chronic-phase hospital who improved within a limited period were discharged to their homes, whereas those who were bedridden tended to be transferred to another hospital.
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Affiliation(s)
- Masatoshi Koumo
- Department of Rehabilitation, Hikari Hospital, Otsu 520-0002, Japan
| | - Akio Goda
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
- Correspondence: ; Tel.: +81-(0)75-574-4313
| | - Yoshinori Maki
- Department of Rehabilitation, Hikari Hospital, Otsu 520-0002, Japan
- Department of Neurosurgery, Hikone Chuo Hospital, Hikone 522-0054, Japan
| | - Kouta Yokoyama
- Department of Rehabilitation, Hikari Hospital, Otsu 520-0002, Japan
| | - Tetsuya Yamamoto
- Department of Rehabilitation, Hikari Hospital, Otsu 520-0002, Japan
| | - Tsumugi Hosokawa
- Department of Rehabilitation, Hikari Hospital, Otsu 520-0002, Japan
| | - Ryota Ishibashi
- Department of Neurosurgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka 530-0025, Japan
| | - Junichi Katsura
- Department of Rehabilitation, Hikari Hospital, Otsu 520-0002, Japan
| | - Ken Yanagibashi
- Department of Rehabilitation, Hikari Hospital, Otsu 520-0002, Japan
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Sako H, Miyazaki M, Suematsu Y, Koyoshi R, Shiga Y, Kuwano T, Kitajima K, Iwata A, Yorinaga K, Fujimi K, Miura SI. A Case of Multifaceted Assessment in an Elderly Patient With Acute Decompensated Heart Failure. Cardiol Res 2017; 8:339-343. [PMID: 29317979 PMCID: PMC5755668 DOI: 10.14740/cr640w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 12/12/2017] [Indexed: 01/19/2023] Open
Abstract
Heart failure (HF) is a common health problem worldwide, including in Japan. Unfortunately, patient outcomes remain poor, with a 5-year survival rate of approximately 50%. Therefore, we need to assess the precise conditions, including cardiac function, in patients with HF, particularly in the elderly. We performed a multifaceted assessment in an elderly patient with HF on admission and at discharge using eight different evaluations (the mean life expectancy using the Seattle Heart Failure Model (SHFM), the severity of dementia, nutrition, medication adherence, biomarker (the level of brain natriuretic peptide in blood), sociality, performance and comorbidity). Each parameter was scored on a 5-point scale (excellent = 5 points; good = 4 points; fair (average) = 3 points; poor = 2 points; failure = 1 point; maximum total points of 40) (Fukuoka University Heart Failure Scoring System, FUFS). An 86-year-old male patient who complained of dyspnea and lower-leg edema was admitted to our university hospital due to acute decompensated HF. After treatment, his symptoms improved, as did his cardiothoracic ratio, plural effusion and pulmonary congestion, and he exhibited compensated HF. His total score improved from 28 to 32 points, and his mean life expectancy using SHFM increased from 4.9 to 5.4 years. We evaluated the precise conditions using a multifaceted assessment strategy in an elderly patient with HF. The strategy was useful for evaluate the patient's condition in this case.
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Affiliation(s)
- Hideto Sako
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Midori Miyazaki
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yasunori Suematsu
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Rie Koyoshi
- Division of Medical Safety Management, Fukuoka University Hospital, Fukuoka, Japan
| | - Yuhei Shiga
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Takashi Kuwano
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Ken Kitajima
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Atsushi Iwata
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Katsura Yorinaga
- Division of Nursing, Fukuoka University Hospital, Fukuoka, Japan
| | - Kanta Fujimi
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
- Division of Rehabilitation, Fukuoka University Hospital, Fukuoka, Japan
| | - Shin-ichiro Miura
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
- Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka, Japan
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Matsugi A, Tani K, Yoshioka N, Yamashita A, Mori N, Oku K, Murakami Y, Nomura S, Tamaru Y, Nagano K. Prediction of destination at discharge from a comprehensive rehabilitation hospital using the home care score. J Phys Ther Sci 2016; 28:2737-2741. [PMID: 27821925 PMCID: PMC5088116 DOI: 10.1589/jpts.28.2737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/09/2016] [Indexed: 12/01/2022] Open
Abstract
[Purpose] This study investigated whether it is possible to predict return to home at
discharge from a rehabilitation hospital in Japan using the home care score of patients
with cerebrovascular or osteoarticular disease and low activities of daily living at
admission. [Subjects and Methods] The home care score and functional independent
measurement were determined for 226 patients at admission and at discharge from five
hospitals, and receiver operating characteristic analyses were conducted. [Results] The
home care score cutoff point for the prediction of return to home at admission and at
discharge was 11, and the area under the curve was more than 0.8. The area under the curve
of the home care score was 0.77 for patients with low activities of daily living and
within this group, the probability of return to home was approximately 50%, as predicted
by the functional independent measurement. The home care score increased after receiving
intervention at a rehabilitation hospital. [Conclusion] The home care score is useful for
the prediction of return to home from a rehabilitation hospital, although prediction using
the functional independent measurement is difficult for patients with low activities of
daily living. Moreover, comprehensive interventions provided by the rehabilitation
hospitals improve the ability to provide home care of the patient’s family, which is
assessed by the home care score.
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Affiliation(s)
| | - Keisuke Tani
- Graduate School of Human and Environmental Studies, Kyoto University, Japan
| | - Nami Yoshioka
- Department of Rehabilitation, Bobath Memorial Hospital, Japan
| | - Akira Yamashita
- Department of Rehabilitation, Bobath Memorial Hospital, Japan
| | - Nobuhiko Mori
- Department of Rehabilitation, Wakayama Medical University, Japan
| | - Kosuke Oku
- Faculty of Rehabilitation, Shijonawate Gakuen University, Japan
| | | | - Shohei Nomura
- Department of Rehabilitation, Pegasus Rehabilitation Hospital, Japan
| | - Yoshiki Tamaru
- Faculty of Rehabilitation, Shijonawate Gakuen University, Japan
| | - Kiyoshi Nagano
- Faculty of Rehabilitation, Shijonawate Gakuen University, Japan
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