Leong K T G, Goh P P, Chang B C, Lingamanaicker J
Division of Cardiology, Changi General Hospital, Singapore 529889.
Singapore Med J. 2007 May;48(5):408-14.
There are limited data on heart failure (HF) cohorts with objective clinical definition of HF. Many observational HF studies were based on discharge diagnosis codes, making them subjective. Many did not have contemporaneous left ventricular function assessment. This study was done to evaluate the characteristics and one-year prognosis of a single centre multi-ethnic Asian inpatient HF cohort, with these limitations addressed, with the aim of yielding a more accurate picture of true HF.
This was an observational prospective study. Patients who fulfilled the modified Framingham criteria for clinical HF and study inclusion criteria of serum creatinine level less than 267 micromol/L, serum albumin level greater than 28 g/L, and a contemporaneous trans-thoracic echocardiography (TTE) study were enrolled. TTE studies ordered were attempted within 72 hours.
173 patients were enrolled into the study. TTE was done within 72 hours of admission for 86.1 percent (n = 149) of the participants. Diastolic HF constituted 22.0 percent of the cohort. The mean age of the participants was 68.7 (standard deviation, 12.0) years. The prevalence of elderly patients, diabetes mellitus, hypertension and ischaemic cardiomyopathy were high. The one-year mortality rate was 20.8 percent (n = 36). The one-year death or readmission for any cause rate was 69.4 percent (n = 120). The mean time in hospital for any cause within the one year was 11.8 +/- 17.9 days. Ethnicity had prognostic implications. Being elderly, having elevated random blood glucose or serum creatinine levels were associated with a worse prognosis.
With strict methodology, HF is truly a disease of the elderly, with significant one-year mortality and morbidity consequences. Prognostic characteristics are reviewed.
关于心力衰竭（HF）队列且有客观临床定义的HF的数据有限。许多观察性HF研究基于出院诊断编码，这使其具有主观性。许多研究没有同期的左心室功能评估。本研究旨在评估一个单中心多民族亚洲住院HF队列的特征和一年预后，解决这些局限性，以更准确地描绘真正的HF情况。
这是一项观察性前瞻性研究。纳入符合修订后的弗明汉临床HF标准以及血清肌酐水平低于267微摩尔/升、血清白蛋白水平高于28克/升且有同期经胸超声心动图（TTE）检查的研究纳入标准的患者。所安排的TTE检查在72小时内进行。
173名患者纳入研究。86.1%（n = 149）的参与者在入院72小时内进行了TTE检查。舒张性HF占队列的22.0%。参与者的平均年龄为68.7（标准差，12.0）岁。老年患者、糖尿病、高血压和缺血性心肌病的患病率较高。一年死亡率为20.8%（n = 36）。因任何原因导致的一年死亡或再入院率为69.4%（n = 120）。一年内因任何原因住院的平均时间为11.8±17.9天。种族具有预后意义。老年、随机血糖或血清肌酐水平升高与预后较差相关。
采用严格的方法，HF确实是一种老年疾病，具有显著的一年死亡率和发病后果。对预后特征进行了综述。
