Pan Daniel, Pellicori Pierpaolo, Walklett Claire, Green Andrew, Masse Anais R, Wood Jason, Purdy Jon, Clark Andrew L
Academic Cardiology Department, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK; Department of Respiratory Sciences, University of Leicester, Leicester, UK.
Academic Cardiology Department, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Trust, Cottingham, UK; Robertson Institute of Biostatistics and Clinical Trials Unit, University of Glasgow, Glasgow, UK.
J Card Fail. 2020 Jul;26(7):555-563. doi: 10.1016/j.cardfail.2020.04.002. Epub 2020 May 18.
Judgement and reaction times during complex tasks like driving may be impaired in older adults with chronic heart failure (HF). This study sought to report the driving habits and reaction times of older patients with HF in a specially designed urban driving simulation.
We conducted a prospective observational study in HF patients and controls. Patients in both groups underwent cognitive testing and screening for depression. Current drivers undertook a questionnaire regarding driving habits followed by an urban road driving simulation consisting of 3 laps. Five separate hazards appeared in the third lap without warning. Reaction times and stopping distances to the hazards were calculated. Of 247 patients with HF approached for the study, 124 had already voluntarily stopped driving owing to HF (n = 92) or other medical conditions (n = 32), 60 had never had a license, and 32 declined to participate. Of the 74 controls approached, 1 was not currently driving owing to a medical condition and 46 declined to participate. Patients in both groups had similar levels of cognitive function, mood and driving habits. 30 patients with HF (mean age, 74 ± 5 years; median NT-proBNP 1510 pg/mL [interquartile range (IQR), 546-3084 pg/L]) and 26 controls (mean age, 73 ± 5 years; median NT-proBNP 135 pg/mL [IQR, 73-182 pg/L]) completed the simulation. During lap 3, there was no difference in the driving speed between patients (mean 22.0 ± 4.5 mph) and controls (mean 21.7 ± 3.3 mph; P = .80). Patients had longer reaction times (median, 1.10 seconds; IQR, 0.98-1.30 seconds) than controls (median, 0.96 seconds; IQR, 0.83-1.10 seconds; P = .02), but there was no difference in stopping distances (patients: median, 43.9 m [IQR, 32.2-49.5 m]; controls: median, 38.1 m [IQR, 32.3-48.8 m]; P = .31).
Many older adults with HF no longer drive. Those who continue to drive seem to be safe to drive on simulated urban roads.
在诸如驾驶等复杂任务中，患有慢性心力衰竭（HF）的老年人的判断力和反应时间可能会受损。本研究旨在报告在专门设计的城市驾驶模拟中，老年HF患者的驾驶习惯和反应时间。
我们对HF患者和对照组进行了一项前瞻性观察研究。两组患者均接受了认知测试和抑郁症筛查。现有的驾驶员填写了一份关于驾驶习惯的问卷，随后进行了一次由3圈组成的城市道路驾驶模拟。在第三圈中出现了5个单独的危险情况，且没有预警。计算了对这些危险情况的反应时间和停车距离。在被邀请参加该研究的247例HF患者中，124例由于HF（n = 92）或其他医疗状况（n = 32）已经自愿停止驾驶，60例从未获得过驾照，32例拒绝参与。在被邀请的74名对照组中，1例由于医疗状况目前没有驾驶，46例拒绝参与。两组患者的认知功能、情绪和驾驶习惯水平相似。30例HF患者（平均年龄74±5岁；NT-proBNP中位数1510 pg/mL[四分位间距（IQR），546 - 3084 pg/L]）和26名对照组（平均年龄73±5岁；NT-proBNP中位数135 pg/mL[IQR，73 - 182 pg/L]）完成了模拟。在第三圈中，患者（平均速度22.0±4.5英里/小时）和对照组（平均速度21.7±3.3英里/小时；P = 0.80）的驾驶速度没有差异。患者的反应时间（中位数1.10秒；IQR，0.98 - 1.30秒）比对照组（中位数0.96秒；IQR，0.83 - 1.10秒；P = 0.02）长，但停车距离没有差异（患者：中位数43.9米[IQR，32.2 - 49.5米]；对照组：中位数38.1米[IQR，32.3 - 48.8米]；P = 0.31）。
许多老年HF患者不再驾驶。那些继续驾驶的人在模拟城市道路上似乎驾驶安全。
