自述症状与心力衰竭住院之间的长期关联:动脉粥样硬化风险社区(ARIC)研究。

Long-term association between self-reported signs and symptoms and heart failure hospitalizations: the Atherosclerosis Risk In Communities (ARIC) Study.

机构信息

Department of Epidemiology, University of North Carolina at Chapel Hill, Bank of America Center, 137 E. Franklin St, Suite 306, Chapel Hill, NC 27514, USA.

出版信息

Eur J Heart Fail. 2010 Mar;12(3):232-8. doi: 10.1093/eurjhf/hfp203. Epub 2010 Jan 22.

Abstract

AIMS

Although studies of the accuracy of heart failure (HF) classification scoring systems are available, few have examined their performance when restricted to self-reported items.

METHODS AND RESULTS

We evaluated the association between a simplified version of the Gothenburg score, a validated HF score comprised of cardiac and pulmonary signs and symptoms and medication use, and incident HF hospitalizations in 15,430 Atherosclerosis Risk in Communities (ARIC) Study participants. Gothenburg scores (range: 0-3) were constructed using self-reported items obtained at study baseline (1987-89). Incident HF hospitalization over 14.7 years of follow-up was defined as the first identified hospitalization with an ICD-9 discharge code of 428 (n = 1,668). Self-reported Gothenburg scores demonstrated very high agreement with the original metric comprised of self-reported and clinical measures and were directly associated with incident HF hospitalizations: [score = 1: hazard rate ratio (HRR) = 1.23 (1.07-1.42); score = 2: HRR = 2.17 (1.92-2.43); score = 3: HRR = 3.98 (3.37-4.70)].

CONCLUSION

In a population-based cohort, self-reported Gothenburg criteria items were associated with hospitalized HF over a prolonged follow-up time. The association was also consistent across groups defined by sex and race, suggesting that this simple score deserves further study as a screening tool for the identification of individuals at high risk of HF in resource-limited settings.

摘要

目的

尽管已有研究评估心力衰竭(HF)分类评分系统的准确性,但很少有研究检验其在仅使用自我报告项目时的表现。

方法和结果

我们评估了哥德堡评分简化版与心力衰竭住院事件之间的关联,该评分是一个经过验证的 HF 评分,包含心脏和肺部体征和症状以及药物使用情况,研究对象为 15430 名动脉粥样硬化风险社区(ARIC)研究参与者。哥德堡评分(范围:0-3)使用研究基线(1987-89 年)时获得的自我报告项目构建。14.7 年的随访期间发生的 HF 住院事件定义为首次确定的住院治疗,ICD-9 出院代码为 428(n=1668)。自我报告的哥德堡评分与包含自我报告和临床测量的原始指标具有非常高的一致性,并且与 HF 住院事件直接相关:[评分=1:危险比(HRR)=1.23(1.07-1.42);评分=2:HRR=2.17(1.92-2.43);评分=3:HRR=3.98(3.37-4.70)]。

结论

在基于人群的队列中,自我报告的哥德堡标准项目与长期随访期间的住院 HF 相关。这种关联在按性别和种族定义的组中也是一致的,这表明这个简单的评分值得进一步研究,作为资源有限环境中识别 HF 高危个体的筛选工具。

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