Nechita A C, Enache V, Stroi A M, Ploesteanu R L, Delcea C, Stamate C S
1st Internal Medicine and Cardiology Department, "Sfantul Pantelimon" Clinical Emergency Hospital Bucharest ; "Carol Davila" University of Medicine and Pharmacy Bucharest.
Neurology Department, Colentina Clinical Hospital Bucharest.
J Med Life. 2013;6(4):440-5. Epub 2013 Dec 25.
The length of hospital stay (LOS) is a unanimously accepted measure of risk and treatment efficacy for in-patients.
Our aim was to identify the parameters with predictive value for the LOS of patients with acute heart failure (AHF).
We analyzed 125 patients consecutively admitted to our clinic with a slight male predominance (54.4%) and a mean age of 71.54 years. Patients were divided into groups according to the clinical form at presentation and left ventricular function. Mean LOS was of 8.74 days.
Patients with LVEF<30% had a significantly higher LOS compared to those with LVEF>30% (F(2)=6.54, p<0.05). The same difference was discovered for those who received inotropic support (p<0.001), i.v. loop diuretic>140mg (p<0.001) as well as for those with QRS>160ms (p<0.05) or LBBB. The linear regression equation exposed a single significant statistical model indicating that the need for vasopressor amines, mean diuretic dose and PAAT<90msec explain 56% of the variance of LOS F(3.46)=20.55, p<0.001. The highest contribution to the model was achieved by the need for vasopressor amines (β=0.66), with a unique contribution of 42% to the variance of the number of days of stay. The mean dose of diuretic had β=0.27 and a unique contribution to the model of 7.2%, followed by PAAT<90 msec with β=0.26 and a unique contribution to the model of 7%.
LOS is influenced by numerous parameters, some specific to certain clinical forms of AHF while others are independent, which is why evaluations on larger groups of patients are further needed.
住院时长（LOS）是衡量住院患者风险和治疗效果的一项公认指标。
我们的目的是确定对急性心力衰竭（AHF）患者住院时长具有预测价值的参数。
我们分析了连续入住我院的125例患者，其中男性略占优势（54.4%），平均年龄为71.54岁。根据就诊时的临床症状和左心室功能将患者分组。平均住院时长为8.74天。
左心室射血分数（LVEF）<30%的患者与LVEF>30%的患者相比，住院时长显著更长（F(2)=6.54，p<0.05）。接受正性肌力药物支持的患者（p<0.001）、静脉注射襻利尿剂>140mg的患者（p<0.001）以及QRS>160ms或左束支传导阻滞（LBBB）的患者也存在同样的差异（p<0.05）。线性回归方程显示了一个显著的统计模型，表明血管升压胺的需求、平均利尿剂剂量和肺动脉加速时间（PAAT）<90毫秒可解释住院时长方差的56%（F(3.46)=20.55，p<0.001）。对该模型贡献最大的是血管升压胺的需求（β=0.66），对住院天数方差的独特贡献为42%。利尿剂的平均剂量β=0.27，对模型的独特贡献为7.2%，其次是PAAT<90毫秒，β=0.26，对模型的独特贡献为7%。
住院时长受众多参数影响，其中一些特定于某些AHF临床症状，而其他参数则是独立的，这就是为什么还需要对更大规模患者群体进行评估的原因。
