I-Yu Hsiaoa, †, Chen-Yu Chienb, †, Chih-Wei Chenb, Tin-Kwang Linc, Malcolm Kood
a Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
b Division of Cardiology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
c Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
d Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
Abstract
Objectives
To investigate baseline factors predictive of lack of improvement in the left ventricular ejection fraction (LVEF) 18 months after the beginning of a disease management program in patients with congestive heart failure.
Materials and methods
Patients in whom congestive heart failure is diagnosed in the cardiology outpatient division in a hospital in southern Taiwan were recruited into a disease management program. Echocardiography was performed at baseline and 18 months after commencement of the program to calculate changes in the LVEF.
Results
Eighteen months after the commencement of the program, 29 of the 76 patients (38%) had no improvement in the LVEF over baseline measurements. Multiple logistic regression analysis indicated a younger age (<70 years), no schooling, not being married, and elevated triglyceride levels (≥150 mg/dL) at baseline were significant and independent predictors of no improvement in the LVEF 18 months after commencement of the program.
Conclusion
Younger age, no schooling, not being married, and elevated triglycerides at baseline emerged as significant and independent predictors of a lack of improvement in the LVEF after 18 months of disease management intervention. These findings can serve as a basis for resource allocation when planning future disease management programs.
Keywords
Case management; Disease management; Heart failure
