Sección de Coordinación Asistencial, SERGAS, Santiago de Compostela, Spain.
Int J Cardiol. 2009 Jul 24;136(1):56-63. doi: 10.1016/j.ijcard.2008.04.025. Epub 2008 Jul 9.
Characterization of current morbidity and mortality among heart failure (HF) outpatients in Galicia (N.W. Spain), together with their main determinants.
Prospective multicentre study involving 149 primary care physicians.
Primary care physicians selected randomly from among all (1959) primary care physicians in Galicia.
Clinical and epidemiological information for 1195 outpatients with HF were collected in 2006, with a mean follow-up of 6.5+/-1.5 months.
Survival rates were calculated by Cox's proportional hazard model.
Mean patient age was 76 years, 48% were male, 82% had a history of arterial hypertension, and 32% ischaemic cardiopathy. Echocardiography had been performed in 67%, showing preserved systolic function in 61%. Ninety-two (8%) died during follow-up [74 (80%) of them from cardiac causes], and 313 (29%) were re-admitted to hospital [230 (73%) of them for cardiac reasons]. Multivariate analysis identified the following independent predictors of cardiovascular death and/or readmission: ischaemic cardiopathy [hazard ratio (HR) 1.76, 95% confidence interval (CI) 1.29-4.40], stroke (HR 1.79, CI 1.18-2.73), oedema (HR 1.49, CI 1.10-2.03), anaemia (HR 1.66, CI 1.21-2.27), deteriorated systolic function (HR 1.62, CI 1.19-2.20), and previous cardiovascular admissions (HR 2.33, CI 1.67-3.24). Residence in the Barbanza district was identified as an independent predictor of survival free from cardiovascular admission (HR 0.56, CI 0.37-0.86).
Morbidity and mortality are currently high among Galician HF patients, and their best single predictor is previous hospitalization for cardiovascular reasons.
描述西班牙加利西亚（西北部）心力衰竭（HF）门诊患者的当前发病率和死亡率特征，以及其主要决定因素。
前瞻性多中心研究，涉及 149 名初级保健医生。
从加利西亚所有（1959 名）初级保健医生中随机选择初级保健医生。
2006 年共收集了 1195 名 HF 门诊患者的临床和流行病学信息，平均随访 6.5+/-1.5 个月。
用 Cox 比例风险模型计算生存率。
患者平均年龄为 76 岁，48%为男性，82%有动脉高血压病史，32%为缺血性心脏病。67%的患者进行了超声心动图检查，显示 61%的患者收缩功能正常。随访期间有 92 例（8%）死亡[74 例（80%）死于心脏原因]，313 例（29%）再次住院[230 例（73%）因心脏原因]。多变量分析确定了心血管死亡和/或再入院的以下独立预测因素：缺血性心脏病[风险比（HR）1.76，95%置信区间（CI）1.29-4.40]、中风（HR 1.79，CI 1.18-2.73）、水肿（HR 1.49，CI 1.10-2.03）、贫血（HR 1.66，CI 1.21-2.27）、收缩功能恶化（HR 1.62，CI 1.19-2.20）和先前的心血管入院（HR 2.33，CI 1.67-3.24）。居住在巴班萨区被确定为免于心血管入院的独立生存预测因素（HR 0.56，CI 0.37-0.86）。
加利西亚心力衰竭患者的发病率和死亡率目前仍然很高，其最佳单一预测因素是先前因心血管原因住院。
