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美国东北部一个社区失代偿性心力衰竭的流行病学

Epidemiology of decompensated heart failure in a single community in the northeastern United States.

作者信息

Goldberg Robert J, Darling Chad, Joseph Bernard, Saczynski Jane, Chinali Marcello, Lessard Darleen, Pezzella Steven, Spencer Frederick A

机构信息

Department of Medicine, University of Massachusetts, Medical School, Worcester, Massachusetts, USA.

出版信息

Am J Cardiol. 2009 Aug 1;104(3):377-82. doi: 10.1016/j.amjcard.2009.03.045. Epub 2009 Jun 6.

Abstract

Limited data are available describing the clinical characteristics, hospital treatment practices, and hospital and long-term death rates of patients hospitalized with decompensated heart failure (HF). To examine the descriptive epidemiology of acute HF in residents of a large New England metropolitan area during the 2 study years of 1995 and 2000, we reviewed the medical records of patients hospitalized with acute HF at 11 medical centers in the Worcester, Massachusetts, metropolitan area during 1995 and 2000 for purposes of collecting information about patients' sociodemographic and clinical characteristics, hospital management approaches, and hospital and postdischarge mortalities. The mean age of 4,537 residents of the Worcester metropolitan area hospitalized with decompensated HF was 76 years, 57% were women, and most study patients had been previously diagnosed with several co-morbidities. The average duration of hospitalization was 6.3 days and 6.8% of patients died during hospitalization. Diuretics (98%) and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (54%) were the most common medications used to treat acutely ill patients. The 1- and 5-year death rates of hospital survivors were 39% and 77%, respectively, with no change observed in these death rates between our 2 study years. In conclusion, the results of this observational study in residents of a central New England metropolitan area provide insights into the characteristics, treatment practices, and short- and long-term death rates associated with this increasingly prevalent clinical syndrome.

摘要

关于失代偿性心力衰竭(HF)住院患者的临床特征、医院治疗方法以及住院和长期死亡率的可用数据有限。为了研究1995年和2000年这两个研究年份中,新英格兰一个大都市地区居民急性HF的描述性流行病学,我们回顾了1995年和2000年期间,马萨诸塞州伍斯特市大都市地区11家医疗中心急性HF住院患者的病历,目的是收集有关患者社会人口统计学和临床特征、医院管理方法以及住院和出院后死亡率的信息。伍斯特大都市地区4537名因失代偿性HF住院的居民平均年龄为76岁,57%为女性,大多数研究患者此前已被诊断患有多种合并症。平均住院时间为6.3天,6.8%的患者在住院期间死亡。利尿剂(98%)和血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂(54%)是治疗急性病患者最常用的药物。医院幸存者的1年和5年死亡率分别为39%和77%,在我们的两个研究年份之间,这些死亡率没有变化。总之,这项对新英格兰中部大都市地区居民进行的观察性研究结果,为了解与这种日益普遍的临床综合征相关的特征、治疗方法以及短期和长期死亡率提供了见解。

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