Cardiology · Medical Literature
[Capacity Management During the Hospital-to-Home Transition Period for Patients With Chronic Heart Failure].
Abstract
Exploring the effects of the hospital-to-home transitional capacity management plan in patients with chronic heart failure. Patients with chronic heart failure who were hospitalized from December 2022 to August 2024 were selected as research subjects and randomly assigned to either a control group or an observation group, with 96 cases in each group. The control group received the conventional nursing plan, while the observation group received the hospital-to-home transitional volume management plan. The main outcome indicator was the rate of achieving dry weight targets two months after discharge. Secondary outcome indicators included self-care ability, and other outcome indicators included 6-minute walking distance and readmission rate. These outcomes were compared between the two groups. Two months after discharge, the rate of achieving normal body weight in the observation group was higher than in the control group (P < 0.05), The 6-minute walking distance in the observation group was greater than in the control group (P < 0.05), The scores for self-care maintenance, self-care management, and self-care confidence in the observation group were all higher than those in the control group (P < 0.05), and the readmission rate in the observation group was lower than that in the control group (P < 0.05). The hospital-family transitional volume management program enhance the self-capacity management ability of patients with chronic heart failure, stabilize the volume load status, and provide a reference for self-capacity management of patients with chronic heart failure.
Clinical relevance
In hospitalized patients with chronic heart failure, does a structured hospital-to-home transitional volume (capacity) management plan, compared with conventional nursing care, improve dry weight attainment, self-care ability, functional exercise capacity, and 30-day readmission rates two months after discharge? __SNAPSHOT__ {"studyDesign":"Randomized controlled trial (parallel-group, two-arm)","setting":"Inpatient cardiology setting, China (specific institution type not reported in abstract); enrollment December 2022 – August 2024","sampleSize":"n = 192 (observation group: n = 96; control group: n = 96)","population":"Adult inpatients with a diagnosis of chronic heart failure; specific inclusion/exclusion criteria (e.g., ejection fraction category, NYHA class, renal function, comorbidities) not reported in the abstract","intervention":"Hospital-to-home transitional volume (capacity) management plan — a structured nursing program spanning the inpatient-to-postdischarge transition period; specific components (e.g., fluid/sodium restriction protocols, remote monitoring, telephone follow-up, home visits) not detailed in the abstract","comparator":"Conventional nursing care (standard inpatient nursing plan; postdischarge components not specified)","primaryOutcome":"Rate of achieving dry weight (target euvolemic body weight) at two months post-discharge","followUp":"Two months post-discharge","fundingSource":"Not reported"}
Key findings
At two months post-discharge, the observation group demonstrated a statistically significantly higher rate of achieving the dry weight target compared with the control group (P < 0.05); absolute rates, relative risk, and confidence intervals were not reported in the abstract, and no NNT can be calculated. The 6-minute walk distance (6MWD) was statistically significantly greater in the observation group than in the control group (P < 0.05); no mean values, between-group differences, or confidence intervals were reported. Scores across all three self-care subscales — self-care maintenance, self-care management, and self-care confidence — were statistically significantly higher in the observation group than in the control group (P < 0.05 for each); specific scale values and effect sizes were not reported. Readmission rate data were referenced as an outcome indicator in the abstract but the result was not provided in the text supplied; accordingly, it cannot be summarized. No adverse event data or safety outcomes were reported in the abstract.
Practice implications
This study suggests that a structured hospital-to-home transitional volume management program is associated with statistically significant improvements in euvolemic weight attainment, self-care capacity (maintenance, management, and confidence), and 6-minute walk distance at two months in patients with chronic heart failure. However, several important limitations prevent confident application to practice at this time. First, only the abstract was available for review; full intervention details, randomization methodology, allocation concealment, blinding procedures, and complete outcome data cannot be assessed. Second, absolute effect sizes, confidence intervals, and NNT/NNH are entirely absent, making it impossible to judge the magnitude of clinical benefit. Third, the patient population is incompletely characterized — HFrEF versus HFpEF, NYHA class, baseline medications (including evidence-based GDMT), renal function, and comorbidities are unreported, substantially limiting generalizability to Western or non-Chinese clinical settings. Fourth, the primary endpoint (dry weight attainment rate) is a process/surrogate outcome; its relationship to hard clinical endpoints such as mortality, hospitalization for heart failure, or quality of life was not established. Fifth, the 2-month follow-up period is short; durability of benefit is unknown. The finding that self-care scores and functional walk distance improved is consistent with and directionally supportive of prior evidence on transitional care models in HF, but this single trial cannot independently change practice. __LIMITATIONS__ Only abstract available; full methodology, intervention components, and complete results cannot be evaluated,Absolute effect sizes, confidence intervals, and p-values for most outcomes not reported; clinical magnitude of benefit cannot be determined,Dry weight attainment is a surrogate/process outcome; impact on mortality, hospitalization rates, or patient-reported quality of life not established,Readmission rate, listed as an outcome, was not reported in the provided abstract text,Patient population incompletely characterized: HF phenotype (HFrEF vs HFpEF), ejection fraction, NYHA class, GDMT use, comorbidities, and renal function not described,Blinding of participants and care providers is likely not feasible for a nursing intervention trial; risk of performance and detection bias not addressed,Short 2-month follow-up precludes assessment of durability or longer-term clinical benefit,Single-country setting limits generalizability to health systems with different infrastructure, nursing ratios, or patient access,Funding source not reported; potential for undisclosed conflicts of interest cannot be excluded,Sample size of 96 per arm may be underpowered to detect differences in readmission rates, a relatively infrequent dichotomous endpoint at 2 months __BOTTOM_LINE_CATEGORY__ promising_but_preliminary __BOTTOM_LINE__ A hospital-to-home transitional volume management program for chronic heart failure patients showed statistically significant improvements in dry weight attainment, self-care scores, and 6-minute walk distance versus conventional nursing at two months, but absolute effect sizes and confidence intervals were not reported, and the readmission outcome was not disclosed in the abstract. The findings are hypothesis-generating and directionally consistent with transitional care literature but are insufficient, as presented, to justify practice change without access to the full publication and replication in diverse populations.