Ibrahim Said A, Burant Christopher J, Kent Kwoh C
The Center for Health Equity Research and Promotion, VA Pittsburgh HealthCare System, Pittsburgh, Pennsylvania 15240, USA.
J Gerontol A Biol Sci Med Sci. 2003 Jan;58(1):56-9. doi: 10.1093/gerona/58.1.m56.
Racial and gender differences in mortality rates have been reported for patients with systolic heart failure. Relatively little is known regarding diastolic heart failure prognosis.
Our sample consisted of 1058 patients 65 years of age or older who were admitted to 30 hospitals in Northeastern Ohio with a principal diagnosis of heart failure and a left ventricular ejection fraction of >/=50% by echocardiogram.
Of the 1058 patients with diastolic heart failure (13% African American and 87% white), African Americans and whites were comparable with respect to history of angina, stroke, being on dialysis, and alcohol use; the proportion of male patients was also comparable. The African American to white adjusted odds ratio for 18-month mortality (all cause) was 1.03 (0.66-1.59). For men versus women (30% vs 70%), the above-mentioned comorbidities were comparable, except women were more likely to have a do not resuscitate status (16% vs 7.3%; p =.000) and to be older (79.5 +/- 8 vs 77 +/- 7; p =.000). Men were more likely to have a history of tobacco use (30% vs 14%; p =.000) and alcohol use (36% vs 15%; p =.000), and a higher serum creatinine level (1.7 +/- 1.2 vs 1.4 +/- 1.1; p =.001). The men to women adjusted odds ratio for 18-month mortality (all cause) was 1.06 (0.76-1.46).
In this cohort of elderly patients admitted with diastolic heart failure, there were no ethnic or gender differences in 18-month mortality rates.
对于收缩性心力衰竭患者，已报道了死亡率方面的种族和性别差异。关于舒张性心力衰竭的预后，人们了解相对较少。
我们的样本包括1058名65岁及以上的患者，他们因心力衰竭为主诊断入住俄亥俄州东北部的30家医院，经超声心动图检查左心室射血分数≥50%。
在1058名舒张性心力衰竭患者中（13%为非裔美国人，87%为白人），非裔美国人和白人在心绞痛病史、中风、接受透析和饮酒方面具有可比性；男性患者比例也相当。非裔美国人与白人18个月死亡率（全因）的校正比值比为1.03（0.66 - 1.59）。对于男性与女性（30%对70%），上述合并症具有可比性，但女性更可能有不进行心肺复苏状态（16%对7.3%；p = 0.000）且年龄更大（79.5±8对77±7；p = 0.000）。男性更可能有吸烟史（30%对14%；p = 0.000）和饮酒史（36%对15%；p = 0.000），且血清肌酐水平更高（1.7±1.2对1.4±1.1；p = 0.001）。男性与女性18个月死亡率（全因）的校正比值比为1.06（0.76 - 1.46）。
在这组因舒张性心力衰竭入院的老年患者中，18个月死亡率不存在种族或性别差异。
