Balsam Paweł, Tymińska Agata, Kapłon-Cieślicka Agnieszka, Ozierański Krzysztof, Peller Michał, Galas Michalina, Marchel Michał, Drożdż Jarosław, Filipiak Krzysztof J, Opolski Grzegorz
I Katedra i Klinika Kardiologii Warszawski Uniwersytet Medyczny.
Kardiol Pol. 2016;74(1):9-17. doi: 10.5603/KP.a2015.0112.
Over the last few decades, the incidence and prevalence of chronic heart failure (HF) have been constantly increasing.
To identify predictors of one-year mortality and hospital readmissions in patients discharged after hospitalisation for HF.
The study included Polish patients who agreed to participate in the Heart Failure Pilot Survey of the European Society of Cardiology and were followed for 12 months. The primary endpoint was all-cause death at 12 months. The secondary endpoint was a composite of all-cause death and readmission for cardiac causes at 12 months.
The final analysis included 629 patients. The primary end point occurred in 68 of 629 patients (10.8%). In multivariate analysis, independent predictors of one-year mortality were: higher New York Heart Association (NYHA) class at admission (odds ratio [OR] 1.90; 95% confidence interval [CI] 1.01-3.59; p = 0.0478), inotropic support during hospitalisation (OR 3.95; 95% CI 1.49-10.47; p = 0.0056), and lower glomerular filtration rate at discharge (OR 0.978; 95% CI 0.961-0.995; p = 0.0117). The secondary endpoint occurred in 278 of 503 patients (55.3%). In multivariate analysis, predictors of secondary endpoint were a history of previous coronary revascularisation (OR 2.403; 95% CI 1.221-4.701; p = 0.002) and inotropic support during hospitalisation (OR 2.521; 95% CI 1.062-5.651; p = 0.009).
Patients discharged after hospitalisation for HF remained at high risk of death and hospital readmission. A previous history of coronary revascularisation, decreased renal function, and worse clinical status at admission with the need for inotropic support were predictors of one-year outcome in Polish patients hospitalised for HF.
在过去几十年中,慢性心力衰竭(HF)的发病率和患病率一直在不断上升。
确定因心力衰竭住院治疗后出院患者一年死亡率和再次入院的预测因素。
该研究纳入了同意参与欧洲心脏病学会心力衰竭试点调查的波兰患者,并对其进行了12个月的随访。主要终点是12个月时的全因死亡。次要终点是12个月时全因死亡和因心脏原因再次入院的综合情况。
最终分析纳入了629例患者。629例患者中有68例(10.8%)发生了主要终点事件。在多变量分析中,一年死亡率的独立预测因素为:入院时纽约心脏协会(NYHA)分级较高(比值比[OR]1.90;95%置信区间[CI]1.01 - 3.59;p = 0.0478)、住院期间使用正性肌力药物支持(OR 3.95;95% CI 1.49 - 10.47;p = 0.0056)以及出院时肾小球滤过率较低(OR 0.978;95% CI 0.961 - 0.995;p = 0.0117)。503例患者中有278例(55.3%)发生了次要终点事件。在多变量分析中,次要终点的预测因素为既往冠状动脉血运重建史(OR 2.403;95% CI 1.221 - 4.701;p = 0.002)和住院期间使用正性肌力药物支持(OR 2.521;95% CI 1.062 - 5.651;p = 0.009)。
因心力衰竭住院治疗后出院的患者仍面临高死亡风险和再次入院风险。既往冠状动脉血运重建史、肾功能下降以及入院时临床状况较差且需要正性肌力药物支持是波兰因心力衰竭住院患者一年预后的预测因素。