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老年心力衰竭住院患者健康相关生活质量的预后价值。

Prognostic value of health-related quality of life in elderly patients hospitalized with heart failure.

机构信息

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Clinical Department of Geriatrics, "Zvezdara" University Hospital, Belgrade, Serbia.

出版信息

Clin Interv Aging. 2019 May 22;14:935-945. doi: 10.2147/CIA.S201403. eCollection 2019.

Abstract

Previous research has shown that poor health-related quality of life (HRQOL) is associated with adverse long-term prognosis in patients with heart failure (HF); however, there have been inconsistencies among studies and not all of them confirmed the prognostic value of HRQOL. In addition, few studies involved elderly patients and most focused on all-cause mortality and HF-related hospitalization as outcomes. The aim of our study was to determine whether HRQOL is a predictor and an independent predictor of long-term cardiac mortality, all-cause mortality, and HF-related rehospitalization in elderly patients hospitalized with HF. This prospective observational study included 200 elderly patients hospitalized with HF in Serbia. HRQOL was measured using the Minnesota Living with Heart Failure questionnaire (MLHFQ). The median follow-up period was 28 months. The primary outcome was cardiac mortality, and all-cause mortality and HF-related rehospitalization were secondary outcomes. Survival analysis was conducted using the Kaplan-Meier method and Cox-proportional hazards regression. Subjects with poor HRQOL (higher than the median MLHFQ score) had a higher probability of cardiac mortality (=0.029) and HF-related rehospitalization (=0.001) during long-term follow-up. Poor HRQOL was an independent predictor of cardiac mortality (HR: 2.051, 95% CI: 1.260-3.339, =0.004), all-cause mortality (HR: 1.620, 95% CI: 1.076-2.438, =0.021), and HF-related rehospitalization (HR: 2.040, 95% CI: 1.290-3.227, =0.002). HRQOL is an independent predictor of long-term cardiac mortality in elderly patients hospitalized with HF. It also independently predicts all-cause mortality and HF-related rehospitalization. HRQOL could be used as a complementary clinical predictive tool in this patient population.

摘要

先前的研究表明,较差的健康相关生活质量(HRQOL)与心力衰竭(HF)患者的不良长期预后相关;然而,研究结果并不一致,并非所有研究都证实了 HRQOL 的预后价值。此外,很少有研究涉及老年患者,而且大多数研究都集中在全因死亡率和 HF 相关住院治疗作为结局。我们的研究旨在确定 HRQOL 是否可预测老年 HF 住院患者的长期心脏死亡率、全因死亡率和 HF 相关再住院率,以及是否可作为独立预测因子。这项前瞻性观察性研究纳入了 200 名在塞尔维亚因 HF 住院的老年患者。使用明尼苏达心力衰竭生活质量问卷(MLHFQ)测量 HRQOL。中位随访时间为 28 个月。主要结局为心脏死亡率,全因死亡率和 HF 相关再住院率为次要结局。使用 Kaplan-Meier 方法和 Cox 比例风险回归进行生存分析。HRQOL 较差(高于 MLHFQ 中位数评分)的患者在长期随访中发生心脏死亡率(=0.029)和 HF 相关再住院率(=0.001)的可能性更高。较差的 HRQOL 是心脏死亡率的独立预测因子(HR:2.051,95%CI:1.260-3.339,=0.004)、全因死亡率(HR:1.620,95%CI:1.076-2.438,=0.021)和 HF 相关再住院率(HR:2.040,95%CI:1.290-3.227,=0.002)的独立预测因子。HRQOL 是老年 HF 住院患者长期心脏死亡率的独立预测因子。它还独立预测全因死亡率和 HF 相关再住院率。HRQOL 可作为该患者人群的补充临床预测工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ce5/6535443/577f0c19d37b/CIA-14-935-g0001.jpg

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