scholarly journals A LITERATURE REVIEW: LOW SODIUM RESTRICTION OF PATIENTS WITH HEART FAILURE ON HOSPITAL READMISSION

2021 ◽  
Vol 9 (2) ◽  
pp. 128
Author(s):  
Septa Meriana Lumbantoruan
Keyword(s):  
Heart Failure ◽  
Literature Review ◽  
Sudden Death ◽  
Beneficial Effect ◽  
Hospital Readmission ◽  
Sodium Intake ◽  
Experimental Studies ◽  
Sodium Restriction ◽  
Low Sodium ◽  
Patients With Heart Failure

<p>Sodium restriction effect on hospital readmission in patients with heart failure (HF) has been questioned for decades. Readmission related to low sodium intake recommendations should be changed as well as mortality. A literature review is needed to summarize the effect of low sodium, especially on readmission and mortality. This literature review aimed to summarize the prevalence of hospital readmission and mortality regarding low sodium intake in patients with HF. The searching process involved four databases; MEDLINE, Embase, EBSCO Health, Cochrane was explored for experimental studies of sodium restriction. Of 77 screened citations from 2000 to 2019 invested in patients with HF, four studies were included. Four studies from four databases were included and explained and it was found that hospital readmission was the outcome of implementing sodium restriction in patients with HF. Low sodium restriction (800 mg – 1800 mg/day) results in higher hospital readmission. Moreover, 1800 mg/day of sodium was followed by higher mortality and higher sudden death in patients with HF. Low sodium restriction did not lower hospital readmission as well as mortality of patients with HF. This article provides the reason, effect, and amount of sodium restriction in patients with HF. The recommendation from this literature review is low sodium restriction has no beneficial effect on readmission and mortality in HF conditions.</p>

scholarly journals Evidence related to sodium restriction in patients with heart failure

2020 ◽  
Vol 73 (4) ◽  
Author(s):  
Mailson Marques de Sousa ◽  
Bernadete de Lourdes André Gouveia ◽  
Taciana da Costa Farias Almeida ◽  
Maria Eliane Moreira Freire ◽  
Francisco de Assis Brito Pereira de Melo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sodium Intake ◽  
Main Tool ◽  
Dietary Sodium ◽  
Protective Measure ◽  
Sodium Restriction ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
Asymptomatic Patients ◽  
Patients With Heart Failure

ABSTRACT Objectives: to analyze the scientific production about sodium restriction in patients with heart failure. Methods: integrative literature review from articles published from 2007 to 2017, located in the CINAHL and Scopus databases. Results: thirteen studies were analyzed. Sodium intake restriction was associated with lower unfavorable clinical outcomes in patients with marked symptomatology. The 24-hour urine sodium dosage was the main tool to assess adherence to the low sodium diet. Conclusions: based on the studies included in this review, in symptomatic patients, dietary sodium restriction should be encouraged in clinical practice as a protective measure for health. However, in asymptomatic patients, it should be well studied.

scholarly journals Interventions for Dietary Sodium Restriction Among Patients with Heart Failure: A Mismatch in the Evidence and Intervention Design (OR22-05-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Marissa Burgermaster ◽  
Rebecca Rudel ◽  
David Seres
Keyword(s):  
Heart Failure ◽  
Social Support ◽  
Perceived Risk ◽  
Sodium Intake ◽  
Dietary Sodium ◽  
Secondary Outcome ◽  
Evidence Based ◽  
Sodium Restriction ◽  
Patients With Heart Failure ◽  
Dietary Sodium Restriction

Abstract Objectives Dietary sodium restriction guidelines are controversial due to a lack of studies assessing their effect on heart failure outcomes. An important aspect of this problem is the effectiveness of behavioral nutrition interventions to reduce patients’ sodium intake. We systematically reviewed randomized controlled trials (RCTs) of sodium restricted diets and descriptive studies relating mediators of behavior to successful adherence to sodium restricted diets in patients with heart failure. Methods We queried PubMed, CINAHL, and Cochrane databases with relevant search terms for studies published in English January 2000-December 2018. Included were RCTs of interventions for heart failure patients, with sodium restriction as a primary or secondary outcome, and quantitative and qualitative descriptive studies of adherence to sodium restricted diets. Included studies may or may not have reported clinical outcomes (health events, quality of life, etc.). Reviewers noted setting, methods, and outcomes as well as theoretical mediators of dietary behavior change in included studies. We then compared behavioral mediators addressed by the RCTs and behavioral mediators identified in the descriptive studies. Results Of 638 studies identified, 445 were excluded by title. 2 reviewers assessed 60 abstracts and included 36 studies in this analysis: 10 RCTs and 26 descriptive studies. 6 of 10 intervention RCTs were successful, but no interventions achieved the recommended 1500 mg/day sodium intake (mean for all studies 3271 mg/day). Interventions that reduced sodium intake were behaviorally focused, were delivered by an RN and/or RD, and included individual feedback and counseling. RCTs intervened only through knowledge, skills, and social support. Behavioral mediators identified in descriptive studies included perceived risk, perceived benefits, outcome expectations, cultural norms, social norms, social support, taste preferences, determinism, self-efficacy, knowledge, skills, and habits. These were not included in the RCTs, which signifies a mismatch between evidence-based moderators of behavior and intervention designs. Conclusions RCTs have been unable to achieve the recommended goal of 1500 mg/day of sodium. More effective interventions should consider evidence-based mediators, rather than focusing on knowledge and skills. Funding Sources Dr. Burgermaster received funding from NHLBI T32 training grant.

Development and validation of the Tool for Pharmacists to Predict 30-day hospital readmission in patients with Heart Failure (ToPP-HF)

2021 ◽  
Author(s):  
Melissa R Riester ◽  
Laura McAuliffe ◽  
Christine Collins ◽  
Andrew R Zullo
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Hospital Readmission ◽  
Left Ventricular Ejection ◽  
Day Hospital ◽  
High Risk Patients ◽  
C Statistic ◽  
Patients With Heart Failure ◽  
Risk Patients ◽  
Development And Validation

Abstract Purpose Pharmacists are well positioned to provide transitions of care (TOC) services to patients with heart failure (HF); however, hospitalizations for patients with HF likely exceed the capacity of a TOC pharmacist. We developed and validated a tool to help pharmacists efficiently identify high-risk patients with HF and maximize their potential impact by intervening on patients at the highest risk for 30-day all-cause readmission. Methods We conducted a retrospective cohort study including adults with HF admitted to a health system between October 1, 2016, and October 31, 2019. We randomly divided the cohort into development (n = 2,114) and validation (n = 1,089) subcohorts. Nine models were applied to select the most important predictors of 30-day readmission. The final tool, called the Tool for Pharmacists to Predict 30-day hospital readmission in patients with Heart Failure (ToPP-HF) relied upon multivariable logistic regression. We assessed discriminative ability using the C statistic and calibration using the Hosmer-Lemeshow goodness-of-fit test. Results The risk of 30-day all-cause readmission was 15.7% (n = 331) and 18.8% (n = 205) in the development and validation subcohorts, respectively. The ToPP-HF tool included 13 variables: number of hospital admissions in previous 6 months; admission diagnosis of HF; number of scheduled medications; chronic obstructive pulmonary disease diagnosis; number of comorbidities; estimated glomerular filtration rate; hospital length of stay; left ventricular ejection fraction; critical care requirement; renin-angiotensin-aldosterone system inhibitor use; antiarrhythmic use; hypokalemia; and serum sodium. Discriminatory performance (C statistic of 0.69; 95% confidence interval [CI], 0.65-0.73) and calibration (Hosmer-Lemeshow P = 0.28) were good. Conclusions The ToPP-HF performs well and can help pharmacists identify high-risk patients with HF most likely to benefit from TOC services.

Abstract 17541: An Education Intervention Focused on Self-monitoring for Symptom and Sodium Intake Improves Adherence to the Low Sodium Diet and Health Outcome in Patients with Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Eun Kyeung Song ◽  
Debra K Moser ◽  
Seok-Min Kang ◽  
Terry A Lennie
Keyword(s):  
Health Outcomes ◽  
Cox Regression ◽  
Sodium Intake ◽  
Control Group ◽  
Education Intervention ◽  
Self Monitoring ◽  
Sodium Diet ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
Patients With Heart Failure

Background: Despite the clinical emphasis on recommending a low sodium diet (LSD), adherence to a LSD remains poor in patients with heart failure (HF). Additional research is needed to determine successful interventions to improve adherence to a LSD and health outcomes. Purpose: To determine the effect of an education intervention on adherence to a LSD and health outcomes. Method: A total of 109 HF patients (age 64±9 years, 29% female) who were non-adherent to LSD, indicating > 3g of 24-hour urinary sodium excretion (24hr UNa) at baseline, were randomly assigned to one of 3 groups: 1) symptom monitoring and restricted 3 gram sodium diet (SMART) group, 2) the telephone monitoring (TM) group, or 3) usual care control group. The SMART group received individualized teaching and guidance of self-monitoring for worsening symptom and sodium intake using symptom and food diary for 4 sessions over 8 weeks. Patients assigned to either of the 2 intervention groups (SMART or TM) received phone calls every 2 weeks over 8 weeks. At 6 months follow-up, adherence to a LSD was assessed using 24hr UNa. Patients were followed for 1 year to determine time to first event of hospitalization or death due to cardiac problems. Repeated measures ANOVA and Cox regression were used to determine the effect of intervention. Results: The SMART group (n=37) showed a significant reduction in sodium intake across time compared to the TM group (n=35) and control group (n=37) (p= .022). In the Cox regression, patients in the SMART group had longer cardiac event-free survival compared to the control group after controlling for age, gender, ejection fraction, angiotensin-converting enzyme inhibitor use, and better blocker use (p=.008). Conclusion: An education intervention focused on self-monitoring for symptom and sodium intake improved adherence to LSD and health outcomes in patients with HF. Helping patients engage in self-monitoring for symptom and sodium intake by themselves can promote better health outcome.

scholarly journals Sodium Sensitivity, Sodium Resistance, and Incidence of Hypertension

Hypertension ◽  
2021 ◽  
Author(s):  
Jiang He ◽  
Jian-Feng Huang ◽  
Changwei Li ◽  
Jing Chen ◽  
Xiangfeng Lu ◽  
...  
Keyword(s):  
Sodium Intake ◽  
Experimental Studies ◽  
Dietary Sodium ◽  
Cross Sectional ◽  
Incident Hypertension ◽  
High Sodium ◽  
Sodium Sensitivity ◽  
Sodium Diet ◽  
Low Sodium ◽  
Increased Risk

Cross-sectional studies have reported that high sodium sensitivity is more common among individuals with hypertension. Experimental studies have also reported various animal models with sodium-resistant hypertension. It is unknown, however, whether sodium sensitivity and resistance precede the development of hypertension. We conducted a feeding study, including a 7-day low-sodium diet (1180 mg/day) followed by a 7-day high-sodium diet (7081 mg/day), among 1718 Chinese adults with blood pressure (BP) <140/90 mm Hg. We longitudinally followed them over an average of 7.4 years. Three BP measurements and 24-hour urinary sodium excretion were obtained on each of 3 days during baseline observation, low-sodium and high-sodium interventions, and 2 follow-up studies. Three trajectories of BP responses to dietary sodium intake were identified using latent trajectory analysis. Mean (SD) changes in systolic BP were −13.7 (5.5), −4.9 (3.0), and 2.4 (3.0) mm Hg during the low-sodium intervention and 11.2 (5.3), 4.4 (4.1), and −0.2 (4.1) mm Hg during the high-sodium intervention ( P <0.001 for group differences) in high sodium-sensitive, moderate sodium-sensitive, and sodium-resistant groups, respectively. Compared with individuals with moderate sodium sensitivity, multiple-adjusted odds ratios (95% CIs) for incident hypertension were 1.43 (1.03–1.98) for those with high sodium sensitivity and 1.43 (1.03–1.99) for those with sodium resistance ( P =0.006 for nonlinear trend). Furthermore, a J-shaped association between systolic BP responses to sodium intake and incident hypertension was identified ( P <0.001). Similar results were observed for diastolic BP. Our study indicates that individuals with either high sodium sensitivity or sodium resistance are at an increased risk for developing hypertension.

scholarly journals Transitional Care Interventions for Patients with Heart Failure: An Integrative Review

2020 ◽  
Vol 17 (8) ◽  
pp. 2925 ◽  
Author(s):  
Hai Mai Ba ◽  
Youn-Jung Son ◽  
Kyounghoon Lee ◽  
Bo-Hwan Kim
Keyword(s):  
Heart Failure ◽  
Hospital Readmission ◽  
Transitional Care ◽  
Hospital Readmissions ◽  
Recovery Period ◽  
Functional Decline ◽  
Integrative Review ◽  
Patients With Heart Failure ◽  
Ed Visits ◽  
The Common

Heart failure (HF) is a life-limiting illness and presents as a gradual functional decline with intermittent episodes of acute deterioration and some recovery. In addition, HF often occurs in conjunction with other chronic diseases, resulting in complex comorbidities. Hospital readmissions for HF, including emergency department (ED) visits, are considered preventable. Majority of the patients with HF are often discharged early in the recovery period with inadequate self-care instructions. To address these issues, transitional care interventions have been implemented with the common objective of reducing the rate of hospital readmission, including ED visits. However, there is a lack of evidence regarding the benefits and adverse effects of transitional care interventions on clinical outcomes and patient-related outcomes of patients with HF. This integrative review aims to identify the components of transitional care interventions and the effectiveness of these interventions in improving health outcomes of patients with HF. Five databases were searched from January 2000 to December 2019, and 25 articles were included.

scholarly journals Timing of sudden death in patients with heart failure

1994 ◽  
Vol 24 (4) ◽  
pp. 963-967 ◽  
Author(s):  
Debra K. Moser ◽  
William G. Stevenson ◽  
Mary A. Woo ◽  
Lynne W. Stevenson
Keyword(s):  
Heart Failure ◽  
Sudden Death ◽  
Patients With Heart Failure
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