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贫血程度对老年心力衰竭患者预后的影响(SPAN-HF 研究)。

Influence of the degree of anaemia on the prognosis of older adults with heart failure (SPAN-HF study).

机构信息

Hospital Municipal de Badalona, Badalona, España.

Hospital Ntra. Sra. de Valme, Sevilla, España.

出版信息

Med Clin (Barc). 2022 Feb 25;158(4):167-172. doi: 10.1016/j.medcli.2021.01.016. Epub 2021 May 4.

Abstract

OBJECTIVE

To assess whether a sustained optimal haemoglobin value in the 3 months after admission for heart failure (HF) decompensation reduces morbidity and mortality during the 12 months after admission for acute HF.

PATIENTS AND METHOD

Retrospective study of the 1408 patients older than 65 years included in the RICA registry divided into 3 groups: no anaemia (group A), recovered anaemia (group B), and persistent anaemia (group C), according to haemoglobin levels on admission, and 3 months after discharge. Kaplan-Meier curves were constructed, comparing the groups using the log-rank test and a Cox regression model was performed to analyse survival.

RESULTS

578 (41.1%), 299 (21.2%) and 531 (37.7%) were included in groups A, B and C, respectively. We recorded a total of 768 deaths and readmissions. There were 23 (4%), 12 (4%) and 49 (9.2%), (p=.001) individuals who died due to HF and 154 (27%), 73 (24%) and 193 (36%) (P<.001) admissions for this pathology, respectively. Patients with persistent anaemia had a higher risk of death (RR 1.29, 95% CI 1.04-1.61, P=.024) or readmission (1.92, 95% CI 1.16-3, 19; P=.012) due to HF.

CONCLUSIONS

Persistent anaemia in the months after admission for HF increases morbidity and mortality in the subsequent year.

摘要

目的

评估心力衰竭(HF)失代偿入院后 3 个月内持续最佳血红蛋白值是否降低急性 HF 入院后 12 个月内的发病率和死亡率。

患者和方法

回顾性研究了 RICA 登记处纳入的 1408 名年龄大于 65 岁的患者,根据入院时和出院后 3 个月的血红蛋白水平将其分为 3 组:无贫血(A 组)、贫血恢复(B 组)和持续贫血(C 组)。构建 Kaplan-Meier 曲线,使用对数秩检验比较组间差异,并进行 Cox 回归模型分析生存情况。

结果

A、B 和 C 组分别有 578(41.1%)、299(21.2%)和 531(37.7%)例患者。我们共记录了 768 例死亡和再入院病例。A、B 和 C 组因 HF 死亡的患者分别为 23(4%)、12(4%)和 49(9.2%)(P=.001),因该疾病入院的患者分别为 154(27%)、73(24%)和 193(36%)(P<.001)。持续贫血的患者死亡(RR 1.29,95%CI 1.04-1.61,P=.024)或因 HF 再入院(1.92,95%CI 1.16-3,19;P=.012)的风险更高。

结论

HF 入院后数月内持续存在贫血会增加随后 1 年内的发病率和死亡率。

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