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心力衰竭患者睡眠问题的病程及其与再次住院的关联

The Course of Sleep Problems in Patients With Heart Failure and Associations to Rehospitalizations.

作者信息

Johansson Peter, Broström Anders, Sanderman Robbert, Jaarsma Tiny

机构信息

Peter Johansson, PhD Associate Professor, Department of Cardiology, and Department of Medicine and Health Sciences, Linköping University, Sweden. Anders Broström, PhD Professor, Department of Clinical Neurophysiology, County Council of Östergötland, and School of Health Sciences, Department of Nursing Science, Jönköping University, Sweden. Robbert Sanderman, PhD Professor, Health Psychology Section, Department of Health Sciences, University of Groningen, University Medical Centre Groningen, the Netherlands. Tiny Jaarsma, PhD Professor, Department of Medicine and Health Sciences Linköping University, Sweden.

出版信息

J Cardiovasc Nurs. 2015 Sep-Oct;30(5):403-10. doi: 10.1097/JCN.0000000000000176.

Abstract

INTRODUCTION

Sleep problems are common in patients with heart failure (HF) and might be associated with patient outcomes.

AIMS

The aim of this study was to describe the course of sleep problems in HF patients over 1 year and the association between sleep problems and rehospitalization.

METHODS

Data from 499 HF patients (mean age, 70 years) were used in this analysis. Sleep problems were assessed with the item "Was your sleep restless" from the Center for Epidemiological Studies Depression Scale during hospitalization for HF (baseline) and after 1 year.

RESULTS

A total of 43% of patients (n = 215) reported sleep problems at baseline, and 21% of patients (n = 105), after 1 year. Among the 215 patients with problems with sleep at baseline, 30% (n = 65) continued to have sleep problems over time. Among the 284 patients without sleep problems at baseline, 14% (n = 40) reported sleep problems after 1 year. After adjustments for potential cofounders, patients with continued sleep problems had an almost 2-fold increased risk for all-cause hospitalizations (hazard ratio, 2.1; P = .002) and cardiovascular hospitalizations (hazard ratio, 2.2; P = .004).

CONCLUSION

One-third of HF patients with sleep problems at discharge experienced persistent sleep problems at follow-up. Continued sleep problems were associated with all-cause and cardiovascular rehospitalizations.

摘要

引言

睡眠问题在心力衰竭(HF)患者中很常见,并且可能与患者的预后相关。

目的

本研究的目的是描述HF患者1年内睡眠问题的变化过程以及睡眠问题与再次住院之间的关联。

方法

本分析使用了499例HF患者(平均年龄70岁)的数据。在因HF住院期间(基线)和1年后,使用流行病学研究中心抑郁量表中的“您的睡眠是否不安稳”这一项目对睡眠问题进行评估。

结果

共有43%的患者(n = 215)在基线时报告有睡眠问题,1年后有21%的患者(n = 105)报告有睡眠问题。在基线时有睡眠问题的215例患者中,30%(n = 65)随着时间的推移持续存在睡眠问题。在基线时没有睡眠问题的284例患者中,14%(n = 40)在1年后报告有睡眠问题。在对潜在混杂因素进行调整后,持续存在睡眠问题的患者全因住院风险增加近2倍(风险比,2.1;P = .002),心血管住院风险增加近2倍(风险比,2.2;P = .004)。

结论

出院时有睡眠问题的HF患者中有三分之一在随访时仍存在持续性睡眠问题。持续存在的睡眠问题与全因和心血管再次住院相关。

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