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老年慢性心力衰竭住院患者的健康相关生活质量。

Health-related quality of life in elderly patients hospitalized with chronic heart failure.

机构信息

Department of Gerontology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia ; Clinical Department of Geriatrics, Zvezdara University Hospital, Belgrade, Serbia.

出版信息

Clin Interv Aging. 2013;8:1539-46. doi: 10.2147/CIA.S53305. Epub 2013 Nov 15.

Abstract

BACKGROUND

Chronic heart failure is a very common condition in the elderly, characterized not only by high mortality rates, but also by a strong impact on health-related quality of life (HRQOL). Previous studies of HRQOL in elderly heart failure subjects have included mostly outpatients, and little is known about determinants of HRQOL in hospitalized elderly population, especially in Serbia. In this study, we tried to identify factors that influence HRQOL in elderly patients hospitalized with chronic heart failure in Serbia.

METHODS

The study population consisted of 136 patients aged 65 years or older hospitalized for chronic heart failure. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire. Predictors of HRQOL were identified by multiple linear regression analysis.

RESULTS

Univariate analysis showed that patients with lower income, a longer history of chronic heart failure, and longer length of hospital stay, as well as those receiving aldosterone antagonists and digoxin, taking multiple medications, in a higher NYHA class, and showing signs of depression and cognitive impairment had significantly worse HRQOL. Presence of depressive symptoms (P<0.001), higher NYHA class (P=0.021), lower income (P=0.029), and longer duration of heart failure (P=0.049) were independent predictors of poor HRQOL.

CONCLUSION

Depressive symptoms, higher NYHA class, lower income, and longer duration of chronic heart failure are independent predictors of poor HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Further, there is an association between multiple medication usage and poor HRQOL, as well as a negative impact of cognitive impairment on HRQOL. Hence, measures should be implemented to identify such patients, especially those with depressive symptoms, and appropriate interventions undertaken in order to improve their HRQOL.

摘要

背景

慢性心力衰竭是老年人中非常常见的病症,不仅具有较高的死亡率,而且对健康相关生活质量(HRQOL)有很大影响。以前对老年心力衰竭患者 HRQOL 的研究大多包括门诊患者,而对于住院老年人群,特别是在塞尔维亚,HRQOL 的决定因素知之甚少。在这项研究中,我们试图确定影响塞尔维亚住院慢性心力衰竭老年患者 HRQOL 的因素。

方法

研究人群由 136 名年龄在 65 岁或以上因慢性心力衰竭住院的患者组成。使用明尼苏达州心力衰竭生活质量问卷评估 HRQOL。通过多元线性回归分析确定 HRQOL 的预测因素。

结果

单因素分析显示,收入较低、慢性心力衰竭病史较长、住院时间较长、接受醛固酮拮抗剂和地高辛、服用多种药物、NYHA 分级较高、出现抑郁和认知障碍的患者 HRQOL 明显较差。抑郁症状的存在(P<0.001)、较高的 NYHA 分级(P=0.021)、较低的收入(P=0.029)和心力衰竭持续时间较长(P=0.049)是 HRQOL 较差的独立预测因素。

结论

抑郁症状、较高的 NYHA 分级、较低的收入和慢性心力衰竭持续时间较长是塞尔维亚住院慢性心力衰竭老年患者 HRQOL 较差的独立预测因素。此外,多种药物使用与 HRQOL 较差之间存在关联,认知障碍对 HRQOL 有负面影响。因此,应采取措施识别此类患者,特别是有抑郁症状的患者,并采取适当的干预措施来改善他们的 HRQOL。

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