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年龄和性别特异性心力衰竭首次住院后死亡风险。

Age- and gender-specific risk of death after first hospitalization for heart failure.

机构信息

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

BMC Public Health. 2010 Oct 22;10:637. doi: 10.1186/1471-2458-10-637.

Abstract

BACKGROUND

Hospitalization for heart failure (HF) is associated with high-in-hospital and short- and long-term post discharge mortality. Age and gender are important predictors of mortality in hospitalized HF patients. However, studies assessing short- and long-term risk of death stratified by age and gender are scarce.

METHODS

A nationwide cohort was identified (ICD-9 codes 402, 428) and followed through linkage of national registries. The crude 28-day, 1-year and 5-year mortality was computed by age and gender. Cox regression models were used for each period to study sex differences adjusting for potential confounders (age and comorbidities).

RESULTS

14,529 men, mean age 74 ± 11 years and 14,524 women, mean age 78 ± 11 years were identified. Mortality risk after admission for HF increased with age and the risk of death was higher among men than women. Hazard ratio's (men versus women and adjusted for age and co-morbidity) were 1.21 (95%CI 1.14 to 1.28), 1.26 (95% CI 1.21 to 1.31), and 1.28 (95%CI 1.24 to 1.31) for 28 days, 1 year and 5 years mortality, respectively.

CONCLUSIONS

This study clearly shows age- and gender differences in short- and long-term risk of death after first hospitalization for HF with men having higher short- and long-term risk of death than women. As our study population includes both men and women from all ages, the estimates we provide maybe a good reflection of 'daily practice' risk of death and therefore be valuable for clinicians and policymakers.

摘要

背景

心力衰竭(HF)住院与院内和出院后短期及长期死亡率高有关。年龄和性别是住院 HF 患者死亡的重要预测因素。然而,评估按年龄和性别分层的短期和长期死亡风险的研究很少。

方法

确定了一个全国性队列(ICD-9 代码 402、428),并通过国家登记处进行了链接。根据年龄和性别计算了 28 天、1 年和 5 年的粗死亡率。在每个时期,使用 Cox 回归模型来研究性别差异,同时调整潜在的混杂因素(年龄和合并症)。

结果

共纳入 14529 名男性,平均年龄 74 ± 11 岁,14524 名女性,平均年龄 78 ± 11 岁。HF 入院后死亡率随年龄增加而增加,男性死亡率高于女性。风险比(男性与女性,调整年龄和合并症后)分别为 1.21(95%CI 1.14 至 1.28)、1.26(95%CI 1.21 至 1.31)和 1.28(95%CI 1.24 至 1.31),用于 28 天、1 年和 5 年死亡率。

结论

本研究清楚地表明,HF 首次住院后短期和长期死亡风险存在年龄和性别差异,男性短期和长期死亡风险均高于女性。由于我们的研究人群包括所有年龄段的男性和女性,因此我们提供的估计值可能很好地反映了“日常实践”的死亡风险,因此对临床医生和决策者具有重要价值。

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