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入院时的肾功能作为首次因心力衰竭住院患者的预后标志物。PREDICE研究结果

Renal function at admission as a prognostic marker for patients hospitalised for a first episode of heart failure. Results of the PREDICE study.

作者信息

Torralba-Morón Á, Guerra-Vales J M, Medrano-Ortega F J, Navarro-Puerto M A, Lora-Pablos D, Marín-León I, Calderón-Sandubete E, Gómez-de la Cámara A

机构信息

Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España.

Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España; Instituto de Investigación, Hospital Universitario 12 de Octubre, Madrid, España.

出版信息

Rev Clin Esp. 2020 Dec;220(9):537-547. doi: 10.1016/j.rce.2019.10.003. Epub 2019 Nov 24.

Abstract

BACKGROUND AND OBJECTIVE

Heart failure (HF) is a frequent condition that deteriorates quality of life and results in high morbidity and mortality. A considerable number of studies have been implemented in recent years to determine the factors that affect the prognosis of HF; however, few studies have assessed the prognosis of patients hospitalised for their first episode of HF. The aim of our study was to analyse the prognostic impact of renal function on patients hospitalised for a first episode of HF.

MATERIAL AND METHODS

We recruited 600 patients hospitalised for a first episode of HF in 3 tertiary Spanish hospitals. We analysed the mortality risk during the first year of follow-up according to renal function at the time of admission.

RESULTS

The patients with the highest degree of kidney failure at admission were older (P<.001), were more often women (p=.01) and presented a higher degree of dependence (P<.05), as well as a higher prevalence of arterial hypertension (P<.001), chronic renal failure (P<.001) and anaemia (P<.001). In the multivariate analysis, the degree of kidney failure at admission remained an independent predictor of increased mortality risk during the first year of follow-up.

CONCLUSIONS

The presence of kidney failure at admission was a marker of poor prognosis in our cohort of patients hospitalised for a first episode of HF.

摘要

背景与目的

心力衰竭(HF)是一种常见病症,会降低生活质量并导致高发病率和死亡率。近年来,已经开展了大量研究以确定影响HF预后的因素;然而,很少有研究评估首次因HF住院患者的预后情况。我们研究的目的是分析肾功能对首次因HF住院患者的预后影响。

材料与方法

我们招募了西班牙3家三级医院中首次因HF住院的600例患者。我们根据入院时的肾功能分析了随访第一年的死亡风险。

结果

入院时肾衰竭程度最高的患者年龄更大(P<0.001),女性比例更高(p=0.01),依赖程度更高(P<0.05),同时动脉高血压(P<0.001)、慢性肾衰竭(P<0.001)和贫血(P<0.001)的患病率也更高。在多变量分析中,入院时的肾衰竭程度仍然是随访第一年死亡风险增加的独立预测因素。

结论

在我们首次因HF住院的患者队列中,入院时存在肾衰竭是预后不良的一个标志。

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