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肌酐和 NT-proBNP 水平可预测心力衰竭失代偿患者的住院时间。

Creatinine and NT-ProBNP levels could predict the length of hospital stay of patients with decompensated heart failure.

机构信息

Unit of Heart Failure and Transplant, La Fe University and Polytechnic Hospital, Valencia, Spain.

Cardiology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.

出版信息

Acta Cardiol. 2021 Dec;76(10):1100-1107. doi: 10.1080/00015385.2020.1871264. Epub 2021 Jan 22.

Abstract

BACKGROUND

Heart failure (HF) is a clinical syndrome that causes high morbidity and mortality with a high number of admissions and sometimes prolonged admissions. This study aimed at assessing whether parameters detected during the first 24 h of admission may predict a prolonged hospital stay in patients admitted to hospital for decompensated HF.

METHODS

From January 2016 to December 2019, 2359 admissions of decompensated HF were recorded. In-hospital transfers, HF, deaths and scheduled admissions were discarded to homogenise the sample. Finally, 1196 patients were included. The sample was divided into two groups: (a) non-prolonged admission ( = 643, admission ≤7 days) or (b) prolonged admission ( = 553, admission >7 days). Clinical, analytical, electrocardiographic and echocardiographic variables obtained during the first 24 h of admission were analysed.

RESULTS

Univariate differences were found at admission in NT-ProBNP, creatinine, history of cardiac surgery, smoking and alcoholism, left and right ventricular ejection fraction, systolic blood pressure and heart rate. The ROC analysis showed significant areas under the curve for the NT-ProBNP (AUC: 0.63, 95% CI: 0.60-0.67;  < 0.001) and creatinine (AUC: 0.69, 95% CI: 0.66-0.72;  < 0.0001). The variables associated with prolonged hospital admission were NT-ProBNP (OR: 1, 95% CI: 1-1;  < 0.001), creatinine (OR: 2.2, 95% CI: 1.8-2.7;  < 0.0001) and previous smoking (OR: 1.5, 95% CI: 0.4-1;  < 0.02).

CONCLUSIONS

Variables such as creatinine and NT-ProBNP at hospital admission may define a subgroup of patients who will probably have a long hospital stay. Therefore, the planning of hospital care and transition to discharge may be enhanced.

摘要

背景

心力衰竭(HF)是一种临床综合征,导致高发病率和死亡率,住院人数众多,有时住院时间延长。本研究旨在评估入院后 24 小时内检测到的参数是否可预测因失代偿性 HF 入院的患者的住院时间延长。

方法

从 2016 年 1 月至 2019 年 12 月,记录了 2359 例失代偿性 HF 的入院。排除院内转科、HF、死亡和计划入院,以使样本同质。最终纳入 1196 例患者。将样本分为两组:(a)非延长入院组(n=643,入院≤7 天)或(b)延长入院组(n=553,入院>7 天)。分析入院后 24 小时内获得的临床、分析、心电图和超声心动图变量。

结果

入院时发现 NT-ProBNP、肌酐、心脏手术史、吸烟和酗酒、左心室和右心室射血分数、收缩压和心率存在差异。ROC 分析显示 NT-ProBNP(AUC:0.63,95%CI:0.60-0.67; <0.001)和肌酐(AUC:0.69,95%CI:0.66-0.72; <0.0001)的曲线下面积有显著差异。与住院时间延长相关的变量为 NT-ProBNP(OR:1,95%CI:1-1; <0.001)、肌酐(OR:2.2,95%CI:1.8-2.7; <0.0001)和既往吸烟(OR:1.5,95%CI:0.4-1; <0.02)。

结论

入院时的肌酐和 NT-ProBNP 等变量可能确定了一组可能需要长时间住院的患者亚组。因此,可增强医院护理计划和过渡到出院的计划。

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