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住院精神分裂症患者的心血管事件:生存分析。

Cardiovascular events in hospitalised patients with schizophrenia: a survival analysis.

机构信息

a Faculty of Sciences , Lebanese University , Beirut , Lebanon.

b Psychiatric Hospital of the Cross , Jal Eddib , Lebanon.

出版信息

Int J Psychiatry Clin Pract. 2019 Jun;23(2):106-113. doi: 10.1080/13651501.2018.1545910. Epub 2019 Feb 10.

Abstract

To evaluate the occurrence of cardiovascular (CV), cerebrovascular events and mortality rates, and compare the predictive ability of two scores, Framingham Risk Score (FRS) and Atherosclerotic Cardiovascular Disease (ASCVD), of detecting a cardiovascular event in a cohort of schizophrenic patients. A cohort of 329 hospitalised schizophrenic patients is being monitored since 1 January 2013. Patients' file review was performed to detect the CV events of interest. Out of the 329 patients with schizophrenia, with a mean study follow-up of 41.07 ± 12.55 months, 29 cardiovascular events were recorded; of those events, we recorded 4 myocardial infarction, 1 stroke, 6 heart failure and 18 cardiovascular deaths. The major composite outcome of cardiovascular events rate was equal to 9.0 per 100 patient-years. The secondary composite outcome of cardiovascular events rate was equal to 7.2 per 100 patient-years (0.072 events per patient). The association between survival curve of patients with high and low CVR according to FRS score tended to significance (RR = 1.90,  = .078). Patients classified as high cardiovascular risk according to ASCVD presented a reduced cardiovascular survival (RR = 3.35,  = .005). The ASCVD items should be included in the medical assessment in any patient with severe mental illness. Key points The major composite outcome of cardiovascular events rate was equal to 9.0 per 100 patient-years. The secondary composite outcome of cardiovascular events rate was equal to 7.2 per 100 patient-years (0.072 events per patient). The association between survival curve of patients with high and low CVR according to FRS score tended to significance. Patients classified as high cardiovascular risk according to ASCVD presented a reduced cardiovascular survival. The ASCVD items should be included in the medical assessment in any patient with severe mental illness.

摘要

为了评估心血管(CV)、脑血管事件和死亡率的发生情况,并比较Framingham 风险评分(FRS)和动脉粥样硬化性心血管疾病(ASCVD)两种评分在检测精神分裂症患者心血管事件中的预测能力,我们对 329 名住院精神分裂症患者进行了监测。自 2013 年 1 月 1 日以来,对患者的病历进行了回顾,以检测感兴趣的 CV 事件。在 329 名精神分裂症患者中,平均研究随访时间为 41.07±12.55 个月,记录了 29 例心血管事件;其中,我们记录了 4 例心肌梗死、1 例中风、6 例心力衰竭和 18 例心血管死亡。主要复合心血管事件发生率为每 100 患者年 9.0 例。次要复合心血管事件发生率为每 100 患者年 7.2 例(0.072 例/患者)。根据 FRS 评分,高和低 CVR 患者的生存曲线之间的关联有统计学意义(RR=1.90,=0.078)。根据 ASCVD 分类为高心血管风险的患者心血管生存能力降低(RR=3.35,=0.005)。在任何患有严重精神疾病的患者的医疗评估中,都应纳入 ASCVD 项目。

关键要点

  • 主要复合心血管事件发生率为每 100 患者年 9.0 例。

  • 次要复合心血管事件发生率为每 100 患者年 7.2 例(0.072 例/患者)。

  • 根据 FRS 评分,高和低 CVR 患者的生存曲线之间的关联有统计学意义。

  • 根据 ASCVD 分类为高心血管风险的患者心血管生存能力降低。

  • 在任何患有严重精神疾病的患者的医疗评估中,都应纳入 ASCVD 项目。

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