Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
Center for Outcomes Research and Evaluation, Yale University, 1 Church Street, Suite 200, New Haven, CT 06510, USA.
Eur Heart J Qual Care Clin Outcomes. 2018 Apr 1;4(2):98-105. doi: 10.1093/ehjqcco/qcx040.
The elderly are at risk of pericarditis from conditions such as malignancy, renal disease, and after cardiac surgery. However, the burden of pericarditis and, especially, the long-term outcomes associated with pericarditis have not been described before among the elderly.
We examined hospitalization rates; in-hospital, 30-day, and 1-year all-cause mortality rates; all-cause 30-day readmission rates; length of stay and health care expenditure for Medicare beneficiaries aged 65 years or older with a principal discharge diagnosis of pericarditis from 1999 to 2012. A total of 45 504 hospitalizations were identified. The hospitalization rate for pericarditis remained stable at 26 per 100 000 person-years across the study period and was consistently higher among men and the oldest old. The adjusted all-cause 30-day mortality rates decreased from 7.6% [95% confidence interval (CI) 6.9-8.2] in 1999 to 5.7% (95% CI 4.5-7.1) in 2012 and all-cause 1-year mortality rates decreased from 19.7% (95% CI 18.8-20.8) in 1999 to 17.3% (95% CI 15.3-20) in 2011 respectively. The 30-day all-cause readmission rate remained unchanged at 18% across the study period. The length of stay ranged from a mean of 5.8 days in 1999 to 5.5 days in 2012. The consumer price index adjusted cost per hospitalization increased from $8404 in 1999 to $9982 in 2012.
The hospitalization rate for acute pericarditis has remained unchanged among older adults. Although mortality rates associated with pericarditis have improved, hospitalization for pericarditis continues to signal a high risk of dying within a year.
老年人由于恶性肿瘤、肾脏疾病和心脏手术后等原因容易患心包炎。然而，老年人患心包炎的负担，特别是与心包炎相关的长期预后，以前尚未被描述。
我们检查了从 1999 年到 2012 年期间，医疗保险受益人的住院率；住院期间、30 天和 1 年的全因死亡率；全因 30 天再入院率；住院时间和医疗保健支出，其主要出院诊断为心包炎，年龄在 65 岁或以上。共确定了 45504 例住院病例。在整个研究期间，心包炎的住院率保持在每 100000 人年 26 例不变，且在男性和最年长的老年人中一直较高。调整后的全因 30 天死亡率从 1999 年的 7.6%（95%置信区间 6.9-8.2）降至 2012 年的 5.7%（95%置信区间 4.5-7.1），全因 1 年死亡率从 1999 年的 19.7%（95%置信区间 18.8-20.8）降至 2011 年的 17.3%（95%置信区间 15.3-20）。30 天全因再入院率在整个研究期间保持不变，为 18%。住院时间从 1999 年的平均 5.8 天到 2012 年的 5.5 天不等。经消费者价格指数调整后的每次住院费用从 1999 年的 8404 美元增加到 2012 年的 9982 美元。
急性心包炎的住院率在老年人中保持不变。尽管心包炎相关死亡率有所改善，但心包炎的住院治疗仍然表明在一年内死亡的风险很高。
