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成年先天性心脏病患者的住院治疗:一项新出现的挑战。

Hospitalizations in adult patients with congenital heart disease: an emerging challenge.

作者信息

Ntiloudi Despoina, Dimopoulos Konstantinos, Tzifa Aphrodite, Karvounis Haralambos, Giannakoulas George

机构信息

Cardiology Department, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kyriakidi str 1, 546 36, Thessaloniki, Greece.

Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UK.

出版信息

Heart Fail Rev. 2021 Mar;26(2):347-353. doi: 10.1007/s10741-020-10026-0. Epub 2020 Sep 10.

Abstract

The vast majority of patients with congenital heart disease (CHD) survive into adulthood, but many face lifelong complications, which often result in a hospital admission. The increasing number of hospitalizations in adults with CHD (ACHD) poses a significant challenge for healthcare systems globally, especially as heart failure (HF) is becoming increasingly common in this population and is the leading cause of morbidity and mortality. Besides HF, other major contributors to this increase in admission volume are hospitalizations related to mild lesions, comorbidities and pregnancies. Ιn-hospital mortality ranges between 0.8 and 6.1%, while hospitalizations related to HF predict medium-term mortality in ACHD population. Understanding the predictors of hospitalization and in-hospital mortality is, therefore, important for ACHD healthcare providers, who should identify patients at risk that require escalation of treatment and/or close monitoring. This article reviews the available literature on hospitalization patterns in ACHD patients, with a focus on HF-related hospital admissions and specific diagnostic subgroups.

摘要

绝大多数先天性心脏病(CHD)患者能够存活至成年,但许多人面临着终身并发症,这常常导致住院治疗。患有先天性心脏病的成年人(ACHD)住院人数不断增加,这给全球医疗系统带来了重大挑战,尤其是心力衰竭(HF)在这一人群中越来越普遍,并且是发病和死亡的主要原因。除了心力衰竭,导致住院人数增加的其他主要因素还包括与轻度病变、合并症和妊娠相关的住院治疗。住院死亡率在0.8%至6.1%之间,而与心力衰竭相关的住院治疗可预测ACHD人群的中期死亡率。因此,了解住院治疗和住院死亡率的预测因素对于ACHD医疗服务提供者来说很重要,他们应该识别出有风险的患者,这些患者需要加强治疗和/或密切监测。本文回顾了关于ACHD患者住院模式的现有文献,重点关注与心力衰竭相关的住院治疗和特定诊断亚组。

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