Effect of Palliative Care for Patients with Heart Failure

Abstract

Palliative care might be beneficial to heart failure. However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the effect of palliative care on heart failure.PubMed, Embase, Web of Science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of palliative care versus usual care on heart failure were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was readmission. Meta-analysis was performed using random-effect model.Five RCTs involving 545 patients were included in the meta-analysis. Overall, compared with control intervention, palliative care intervention was found to significantly reduce the readmission [Std. mean difference = 0.79; 95% confidence intervals (CI) = 0.23 to 1.35; P = 0.006], Edmonton Symptom Assessment Scale (ESAS) (Std. mean difference = -2.5; 95% CI = -4.39 to -0.62; P = 0.009), and PHQ-9 (Std. mean difference = -1.16; 95% CI = -1.73 to -0.58; P < 0.005), as well as improve heart failure questionnaire (Std. mean difference = 4.46; 95% CI = 3.44 to 5.47; P < 0.005), but had no influence on mortality (RR = 1.54; 95% CI = 0.80 to 2.96; P = 0.19) and quality of life questionnaire (Std. mean difference = 1.81; 95% CI = -0.14 to 3.77; P = 0.07).Compared with control intervention, palliative care intervention was found to significantly reduce readmission, ESAS, PHQ-9, and improve heart failure questionnaire, but showed no influence on mortality and quality of life questionnaire in patients with heart failure.

Efficacy of Cognitive Behavioral Therapy for Heart Failure

“…Major depression is a common comorbidity in patients with heart failure [30][31][32] and results in poor quality of life, an increased risk for hospitalization, and mortality. [33][34][35][36][37][38][39] A vast majority of heart failure patients have symptoms of depression and anxiety. 3) Depressive symptoms show a strong negative impact on quality of life.…”

Successful Peritoneal Dialysis for the Treatment of Inotrope-Dependent End-Stage Heart Failure

“…Advanced HF, also defined as stage D HF, is refractory to medical treatment, especially when patients have coexisting chronic renal failure. [1][2][3][4][5] Under these conditions, extra-and/or intracorporeal renal replacement therapy can improve cardiorenal hemodynamics. It reduces the intravascular volume, corrects acid-base and electrolyte imbalances, and removes uremic toxins, including cytokines.…”

“…eart failure (HF) is a progressive disorder whose treatment options are limited and typically ineffective once patients develop end-stage HF. [1][2][3][4] Mortality is especially high when such patients have coexisting chronic renal failure. 5) Under these conditions, extra-and/or intracorporeal renal replacement therapy can improve the cardiorenal hemodynamics.…”

Independent Prognostic Value of Pulmonary Diffusing Capacity in Nonsmoking Patients with Chronic Heart Failure

“…Besides the conventional parameters that we selected in this study, various prognostic factors have been reported. [41][42][43] In the next study, we will reselect parameters for the analysis, considering also the multicollinearity.…”