Komaki Tomo, Miura Shin-Ichiro, Arimura Tadaaki, Shiga Yuhei, Morii Joji, Kuwano Takashi, Imaizumi Satoshi, Kitajima Ken, Iwata Atsushi, Morito Natsumi, Yahiro Eiji, Fujimi Kanta, Matsunaga Akira, Saku Keijiro
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan; Department of Laboratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan.
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan; Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka, Japan.
J Clin Med Res. 2017 Mar;9(3):200-206. doi: 10.14740/jocmr2890w. Epub 2017 Jan 25.
In our experience, the change in body weight (BW) during hospitalization varies greatly in patients with acute decompensated heart failure (HF). Since the clinical significance of a change in BW is not clear, we investigated whether a change in BW could predict mortality.
We retrospectively enrolled 130 patients (72 males; aged 68 ± 10 years) who were hospitalized due to acute decompensated HF and followed for 2 years after discharge. The change in the BW index during hospitalization (ΔBWI) was calculated as (BW at hospital admission minus BW at hospital discharge)/body surface area at hospital discharge.
The patients were divided into quartiles according to ΔBWI, and the 2-year mortality rates in the quartiles with the lowest, second, third and highest ΔBWI were 18.8%, 12.1%, 3.1% and 9.1%, respectively. In a multivariate Cox proportional hazards analysis after adjusting for variables with a P value less than 0.05, ΔBWI was independently associated with 2-year mortality (P = 0.0002), and the quartile with the lowest ΔBWI had a higher relative risk (RR) for 2-year mortality than the quartile with the highest ΔBWI (RR: 7.46, 95% confidence interval: 1.03 - 53.99, P = 0.04).
In conclusion, ΔBWI was significantly associated with 2-year mortality after discharge, which indicates that ΔBWI might be a simple predictor of prognosis in acute decompensated HF.
根据我们的经验,急性失代偿性心力衰竭(HF)患者住院期间体重(BW)变化差异很大。由于体重变化的临床意义尚不清楚,我们研究了体重变化是否可以预测死亡率。
我们回顾性纳入了130例因急性失代偿性HF住院的患者(72例男性;年龄68±10岁),并在出院后随访2年。住院期间体重指数变化(ΔBWI)计算为(入院体重减去出院体重)/出院时体表面积。
根据ΔBWI将患者分为四分位数,ΔBWI最低、第二、第三和最高四分位数的2年死亡率分别为18.8%、12.1%、3.1%和9.1%。在对P值小于0.05的变量进行校正后的多因素Cox比例风险分析中,ΔBWI与2年死亡率独立相关(P = 0.0002),ΔBWI最低的四分位数2年死亡率的相对风险(RR)高于ΔBWI最高的四分位数(RR:7.46,95%置信区间:1.03 - 53.99,P = 0.04)。
总之,ΔBWI与出院后2年死亡率显著相关,这表明ΔBWI可能是急性失代偿性HF预后的一个简单预测指标。