Effect of TCM non-drug therapy on readmission rate and mortality in patients with chronic heart failure / 中华全科医师杂志

ABSTRACT

Objective:To analyze the effect of traditional Chinese medicine (TCM) non-drug therapy on all-cause mortality and 12-month readmission in patients with chronic heart failure.Methods:A total 824 patients aged (80±10) years with chronic heart failure admitted to 4 hospitals in Shanghai Pudong New Area from January 2016 to December 2019 were retrospectively enrolled. Propensity score match (PSM) method was used and 602 patients (301 pairs) were successively matched into TCM non-drug group (study group) and control group. The basic information, comorbidities, medication, laboratory test results, imaging findings, 12-month readmission and all-cause mortality after discharge were compared between two groups. Cox regression was used to analyze the influencing factors of adverse events in patients with chronic heart failure.Results:After PSM there were no significant differences in baseline variables between study group and control group ( P>0.05). The one-year survival probability of the study group was higher than that of the control group ( P=0.013). The adverse event incidence rate [43.52% ( n=131) vs. 53.82% ( n=162)], all-cause mortality [15.61% ( n=47) vs. 23.59% ( n=71)], 3-month readmission [10.96% ( n=33) vs. 17.61% ( n=53)], 6-month readmission [16.90% ( n=51) vs. 24.25% ( n=73s)], cardiac function classification, hs-CRP and NT-proBNP levels in study group were significantly lower than those in control group (all P<0.05). The Cox proportional risk model showed that old age ( RR=1.018, P<0.01), decreased cardiac function ( RR=2.200, P<0.01), diabetes ( RR=1.340, P=0.04), NT-proBNP≥7 900 ng/L( RR=1.557, P=0.01) were risk factors, while TCM non-drug therapy ( RR=0.768, P=0.04) was protective factor for the occurrence of adverse events. Conclusion:TCM non-drug therapy has a protective role for the occurrence of adverse events in patients with chronic heart failure. The use of TCM non-drug therapy should be advocated to improve the prognosis of patients, particularly at grassroots level.