脉压可预测老年患者的死亡率。
Pulse pressure predicts mortality in elderly patients.
机构信息
Geriatric Ward, Rabin Medical Center, Petah Tikvah, Israel.
出版信息
J Gen Intern Med. 2009 Aug;24(8):893-6. doi: 10.1007/s11606-009-1008-7. Epub 2009 May 27.
BACKGROUND
Pulse pressure (PP) values increase with age. The impact of PP on mortality in elderly patients has not been established.
OBJECTIVES
To evaluate the effect of PP on mortality among very elderly hospitalized patients.
DESIGN
A prospective clinical study.
PARTICIPANTS AND MEASUREMENTS
The medical records of 420 inpatients aged >60 (187 males, mean age of 81.4 +/- 7 years) hospitalized in an acute geriatric ward were reviewed. Patients were followed up for a mean of 3.46 +/- 1.87 years. Mortality data were extracted from death certificates. Using relative operating characteristic (ROC) curves, we identified PP of 62.5 mmHg as a cutoff point. Subjects were categorized as having low PP (< or = 62.5 mmHg; N = 116) or high PP (>62.5 mmHg; N = 304).
MAIN RESULTS
The mortality rate was greater in patients with high PP than in those with low PP. During the follow-up, 201 patients died, 155 patients (51%) in the high PP group and 46 patients (39.7%) in the low PP group (p = 0.038). Pulse pressure was associated with all-cause mortality (HR = 1.69, 95% CI = 1.19-2.38, p = 0.003) even after controlling for gender, age, diabetes mellitus, atrial fibrillation and heart rate.
CONCLUSION
High PP is an independent predictor of mortality among elderly hospitalized patients.
背景
脉压（PP）随年龄增长而增加。PP 对老年患者死亡率的影响尚未确定。
目的
评估脉压对高龄住院患者死亡率的影响。
设计
前瞻性临床研究。
参与者和测量
回顾了在急性老年病房住院的 420 名年龄>60 岁的患者（187 名男性，平均年龄 81.4±7 岁）的病历。对患者进行了平均 3.46±1.87 年的随访。从死亡证明中提取死亡率数据。使用相对工作特征（ROC）曲线，我们将 62.5mmHg 的 PP 确定为截断点。将患者分为低 PP（≤62.5mmHg；N=116）或高 PP（>62.5mmHg；N=304）。
主要结果
高 PP 患者的死亡率高于低 PP 患者。在随访期间，201 名患者死亡，高 PP 组 155 名（51%），低 PP 组 46 名（39.7%）（p=0.038）。脉压与全因死亡率相关（HR=1.69，95%CI=1.19-2.38，p=0.003），即使在校正性别、年龄、糖尿病、心房颤动和心率后也是如此。
结论
高 PP 是老年住院患者死亡率的独立预测因子。
Zotero 插件