Study on the construction and application effect of discharge preparation services in heart valve replacement surgery
- 1Department of Cardiovascular Surgery, The Second Hospital of Tianjin Medical University
Abstract
Objective: To develop and evaluate a discharge preparation service (DPS) for patients after heart valve replacement surgery.
Method: This retrospective cohort study included 323 patients who underwent heart valve replacement surgery between February 2023 and January 2025. A multidisciplinary DPS plan was developed using a modified Delphi method and implemented in clinical practice. After 1:1 propensity score matching, 110 patients receiving DPS and 110 receiving usual care were analyzed. RHDS and QDTS were assessed at discharge; CSMS, CCQQ, and NSNS were assessed at discharge and at 3 and 6 months after discharge. Linear mixed models examined time, group, and time × group interactions.
Results: All items in the DPS plan were agreed upon by experts (average importance score ≥4.0, coefficient of variation ≤0.25), with a Kendall's coefficient of concordance W value of 0.925 ( P < 0.001), and the expert authority coefficient was 0.914. After propensity score matching (PSM), there were no significant differences in baseline characteristics between the two groups ( P > 0.05, standardized mean difference <0.1). Compared with controls, the DPS group had significantly higher RHDS and QDTS scores at discharge ( P < 0.05). For CSMS, CCQQ, and NSNS, time × group interactions were significant [CSMS: F(2,436) = 77.73; CCQQ: F(2,436) = 93.92; NSNS: F(2,436) = 67.53; all P < 0.001], indicating steeper improvement trajectories with DPS. At 6 months after discharge, the interaction estimates were 11.23 (95% CI 9.23–13.23) for CSMS, 15.61 (95% CI 13.36–17.86) for CCQQ, and 10.40 (95% CI 8.60–12.20) for NSNS (all P < 0.001). DPS was associated with lower unplanned readmission (6.36% vs. 15.45%, P = 0.031) and lower total complications (25.45% vs. 59.09%, P < 0.001).
Conclusion: The systematic, multidisciplinary DPS plan was associated with significant improvements in discharge readiness, self-management ability, and quality of life, as well as lower rates of unplanned readmissions and complications after heart valve replacement surgery.
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BibTeX
@article{zhang2026study,
title = {{Study on the construction and application effect of discharge preparation services in heart valve replacement surgery}},
author = {Chunyan Zhang and Huan Yu and Wei Zhai and Lili Zhang and Ting Zhang and Yuanyuan Li},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1879911},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1879911/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Study on the construction and application effect of discharge preparation services in heart valve replacement surgery
AU - Chunyan Zhang
AU - Huan Yu
AU - Wei Zhai
AU - Lili Zhang
AU - Ting Zhang
AU - Yuanyuan Li
PY - 2026
DA - 2026/10/30
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1879911
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1879911/full
AB - Objective: To develop and evaluate a discharge preparation service (DPS) for patients after heart valve replacement surgery. Method: This retrospective cohort study included 323 patients who underwent heart valve replacement surgery between February 2023 and January 2025. A multidisciplinary DPS plan was developed using a modified Delphi method and implemented in clinical practice. After 1:1 propensity score matching, 110 patients receiving DPS and 110 receiving usual care were analyzed. RHDS and QDTS were assessed at discharge; CSMS, CCQQ, and NSNS were assessed at discharge and at 3 and 6 months after discharge. Linear mixed models examined time, group, and time × group interactions. Results: All items in the DPS plan were agreed upon by experts (average importance score ≥4.0, coefficient of variation ≤0.25), with a Kendall's coefficient of concordance W value of 0.925 ( P < 0.001), and the expert authority coefficient was 0.914. After propensity score matching (PSM), there were no significant differences in baseline characteristics between the two groups ( P > 0.05, standardized mean difference <0.1). Compared with controls, the DPS group had significantly higher RHDS and QDTS scores at discharge ( P < 0.05). For CSMS, CCQQ, and NSNS, time × group interactions were significant [CSMS: F(2,436) = 77.73; CCQQ: F(2,436) = 93.92; NSNS: F(2,436) = 67.53; all P < 0.001], indicating steeper improvement trajectories with DPS. At 6 months after discharge, the interaction estimates were 11.23 (95% CI 9.23–13.23) for CSMS, 15.61 (95% CI 13.36–17.86) for CCQQ, and 10.40 (95% CI 8.60–12.20) for NSNS (all P < 0.001). DPS was associated with lower unplanned readmission (6.36% vs. 15.45%, P = 0.031) and lower total complications (25.45% vs. 59.09%, P < 0.001). Conclusion: The systematic, multidisciplinary DPS plan was associated with significant improvements in discharge readiness, self-management ability, and quality of life, as well as lower rates of unplanned readmissions and complications after heart valve replacement surgery.
SN - 2297-055X
ER -