三级护理医院中合并其他疾病的心力衰竭患者药物治疗效果的回顾性研究
A Retrospective Study of the Treatment Outcome of Drug Therapies used in Heart Failure Patients with Associated Co-morbidities in a Tertiary Care Hospital.
作者信息
Thanusubramanian Harish, Kishore Meena Kumari Kamal, Shetty Ranjan, Amberkar Mohan Babu
机构信息
Tutor, Department of Pharmacology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
Associate Professor, Department of Pharmacology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
出版信息
J Clin Diagn Res. 2016 Jun;10(6):FC06-9. doi: 10.7860/JCDR/2016/18636.7989. Epub 2016 Jun 1.
INTRODUCTION
Heart failure is one of the most common heart problems seen in the Indian population. There are various drugs used to prevent further progression of the disease. In India, there are few studies in relation to treatment outcome in a tertiary care hospital.
AIM
To study the treatment outcome of drug therapies used in heart failure patients with associated co-morbidities in a tertiary care hospital.
MATERIALS AND METHODS
This was an observational study conducted on 250 patients with heart failure. Details collected using the proforma were demography (age, gender); medical history; medication history for heart failure patients on admission and discharge; ejection fraction; median length of stay in hospital; number of readmissions & in-hospital mortality.
RESULTS
One hundred and twenty eight patients categorized into LVSD group (ejection fraction <40%) and 122 patients in PSF group (ejection fraction > 40%). Medical history of coronary artery disease (54%) was significantly higher in LVSD group (p<0.05) and anaemia (19%) was significantly higher in PSF group (p<0.05). On admission, inotropes (30%), digoxin (59%) and statins (54%) were prescribed more in LVSD patients (p<0.05) while calcium channel blockers (20%) were prescribed more in PSF group (p<0.05). At discharge, patients with LVSD were receiving ACE inhibitors (51%), beta blockers (30%), digoxin (67%) and statins (59%) (p<0.05) while calcium channel blockers (20%) was prescribed more in PSF group. The median length of stay was slightly higher in patients with PSF (7 days) as compared to LVSD (6 days). In-hospital mortality was lower in patients with PSF (6%) than patients with LVSD (20%). The percentage of readmissions within one month was slightly higher in patients with PSF (15%) compared to LVSD (14%).
CONCLUSION
Length of stay in hospital was 6-7 days in heart failure patients. In hospital mortality in LVSD patients (20%) was higher compared to PSF patients (6%). A 15% heart failure patient were readmitted within 1month of discharge.
引言
心力衰竭是印度人群中最常见的心脏问题之一。有多种药物用于预防该疾病的进一步发展。在印度，关于三级护理医院治疗结果的研究较少。
目的
研究三级护理医院中合并其他疾病的心力衰竭患者药物治疗的结果。
材料与方法
这是一项针对250例心力衰竭患者的观察性研究。使用表格收集的详细信息包括人口统计学特征（年龄、性别）；病史；心力衰竭患者入院和出院时的用药史；射血分数；住院中位时间；再入院次数和院内死亡率。
结果
128例患者被归入左室收缩功能障碍组（射血分数<40%），122例患者在射血分数保留的心衰组（射血分数>40%）。左室收缩功能障碍组冠状动脉疾病病史（54%）显著高于射血分数保留的心衰组（p<0.05），射血分数保留的心衰组贫血（19%）显著高于左室收缩功能障碍组（p<0.05）。入院时，左室收缩功能障碍患者使用正性肌力药物（30%）、地高辛（59%）和他汀类药物（54%）的比例更高（p<0.05），而射血分数保留的心衰组钙通道阻滞剂（20%）的使用比例更高（p<0.05）。出院时，左室收缩功能障碍患者接受血管紧张素转换酶抑制剂（51%）、β受体阻滞剂（30%）、地高辛（67%）和他汀类药物（59%）的比例更高（p<0.05），而射血分数保留的心衰组钙通道阻滞剂（20%）的使用比例更高。射血分数保留的心衰组患者的住院中位时间（7天）略高于左室收缩功能障碍组（6天）。射血分数保留的心衰组患者的院内死亡率（6%）低于左室收缩功能障碍组（20%）。射血分数保留的心衰组患者出院后1个月内的再入院率（15%）略高于左室收缩功能障碍组（14%）。
结论
心力衰竭患者的住院时间为6 - 7天。左室收缩功能障碍患者的院内死亡率（20%）高于射血分数保留的心衰患者（6%）。15%的心力衰竭患者在出院后1个月内再次入院。
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