Department of Internal Medicine, University of Nevada Reno School of Medicine, Reno, NV, USA.
Department of Cardiology, St. Joseph's Regional Medical Center, Paterson, NJ, USA.
Int J Cardiol. 2018 Oct 15;269:289-291. doi: 10.1016/j.ijcard.2018.07.069. Epub 2018 Jul 17.
The aim of our study was to analyze the trends in use of pulmonary artery catheterization (PAC) in heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) and adjusted mortality from 2005 to 2014 using National Inpatient Sample (NIS) database.
The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes were used to identify patients with HFrEF and HFpEF from the National Inpatient Sample database.
We identified a total of 3,225,529 hospitalizations with HFrEF and 3,419,834 hospitalizations with HFpEF. Per 1000 hospitalizations, use of PAC declined from 2005 to 2010 in both HFrEF (12.9 to 7.9, P < 0.001) and HFpEF (12.9 to 5.5, P < 0.001). However, from 2010 to 2014, the use of PAC per 1000 hospitalizations increased in both HFrEF (7.9 to 9.7, P < 0.001) and HFpEF (5.5 to 6.7, P < 0.001). We noted a temporal decline in risk-adjusted mortality during the study period for HFrEF (odds ratio, 3.93 in 2005-06 to 2.7 in 2013-14, P < 0.001) and HFpEF (odd ratio, 2.72 in 2005-06 to 2.62 in 2013-14, P < 0.001). The length of stay and cost were significantly higher with PAC use in both HFrEF and HFpEF.
The use of PAC declined from 2005 to 2010 in both HFrEF and HFpEF but has since increased from 2010 to 2014 in both HFrEF and HFpEF. There is also a temporal decline in excess mortality associated with PAC use in both HFrEF and HFpEF from 2005 to 2014.
本研究旨在利用国家住院患者样本数据库（National Inpatient Sample，NIS），分析 2005 年至 2014 年期间射血分数降低的心力衰竭（HFpEF）和射血分数保留的心力衰竭（HFpEF）患者中肺动脉导管（PAC）使用率和调整死亡率的变化趋势。
利用国际疾病分类，第九版，临床修正版（ICD-9-CM）诊断代码从 NIS 数据库中识别出 HFpEF 和 HFrEF 患者。
共确定了 3225529 例 HFpEF 住院患者和 3419834 例 HFpEF 住院患者。每 1000 例住院患者中，PAC 的使用率从 2005 年到 2010 年在 HFrEF（12.9 至 7.9，P<0.001）和 HFpEF（12.9 至 5.5，P<0.001）中均呈下降趋势。然而，从 2010 年到 2014 年，每 1000 例住院患者中 PAC 的使用率在 HFrEF（7.9 至 9.7，P<0.001）和 HFpEF（5.5 至 6.7，P<0.001）中均有所增加。我们注意到，在研究期间，HFpEF 的风险调整死亡率呈下降趋势（2005-06 年比值比为 3.93，2013-14 年比值比为 2.7，P<0.001），HFpEF（2005-06 年比值比为 2.72，2013-14 年比值比为 2.62，P<0.001）。在 HFrEF 和 HFpEF 中，PAC 的使用均与住院时间和费用的增加显著相关。
2005 年至 2010 年，HFrEF 和 HFpEF 中 PAC 的使用率均呈下降趋势，但自 2010 年以来，HFrEF 和 HFpEF 中 PAC 的使用率均有所增加。2005 年至 2014 年，HFrEF 和 HFpEF 中与 PAC 使用相关的超额死亡率也呈下降趋势。
