老年医疗保险受益人的心力衰竭死亡率：与左心室功能评估及血管紧张素转换酶抑制剂使用的关联
Heart failure mortality among older Medicare beneficiaries: association with left ventricular function evaluation and angiotensin-converting enzyme inhibitor use.
作者信息
Ahmed Ali, Maisiak Richard, Allman Richard M, DeLong James F, Farmer Robert
机构信息
Division of Gerontology and Geriatric Medicine, Department of Medicine, Center for Aging, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294-2041, USA.
出版信息
South Med J. 2003 Feb;96(2):124-9. doi: 10.1097/01.SMJ.0000051271.11872.50.
BACKGROUND
Left ventricular function evaluation and angiotensin-converting enzyme (ACE) inhibitor use are the two basic indicators of heart failure quality of care. In this retrospective follow-up study, we analyzed the association between these two quality indicators and mortality in elderly hospitalized heart failure patients.
METHODS
The patients in our study were older Alabama Medicare beneficiaries discharged with a diagnosis of heart failure in 1994. Cox regression analyses, adjusted for various patient and care characteristics, were performed to estimate the overall mortality rate.
RESULTS
The mean age of the 1,090 patients in our study was 79+/-7.5 years. Both left ventricular function evaluation (hazard ratio, 0.83; 95% confidence interval, 0.705-0.976) and ACE inhibitor use (hazard ratio, 0.77; 95% confidence interval, 0.655-0.905) were associated with a lower 3-year mortality rate. Adjustment for various patient and care characteristics did not alter these associations.
CONCLUSION
Left ventricular function evaluation and ACE inhibitor use were each associated with increased survival time in older Medicare beneficiaries with heart failure.
背景
左心室功能评估和血管紧张素转换酶（ACE）抑制剂的使用是心力衰竭医疗质量的两项基本指标。在这项回顾性随访研究中，我们分析了这两项质量指标与老年住院心力衰竭患者死亡率之间的关联。
方法
我们研究中的患者是1994年诊断为心力衰竭并出院的阿拉巴马州老年医疗保险受益人。进行了Cox回归分析，并对各种患者和护理特征进行了调整，以估计总体死亡率。
结果
我们研究中的1090名患者的平均年龄为79±7.5岁。左心室功能评估（风险比，0.83；95%置信区间，0.705 - 0.976）和ACE抑制剂的使用（风险比，0.77；95%置信区间，0.655 - 0.905）均与较低的3年死亡率相关。对各种患者和护理特征进行调整并未改变这些关联。
结论
左心室功能评估和ACE抑制剂的使用均与老年医疗保险心力衰竭受益人存活时间的延长相关。
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