衰弱与心力衰竭患者 90 天内非计划性再入院和死亡相关：中国的一项纵向研究。

Frailty is associated with 90-day unplanned readmissions and death in patients with heart failure: A longitudinal study in China.

机构信息

Department of Nursing, First People's Hospital of Yunnan, 157 Jinbi Road, Xishan District, Kunming, Yunnan 650032, PR China; The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan 650032, PR China; School of Nursing, Lanzhou University, NO.28 Yanxi Road, Lanzhou, Gansu 730000, PR China.

School of Nursing, Lanzhou University, NO.28 Yanxi Road, Lanzhou, Gansu 730000, PR China; Evidence-Based Nursing Center, School of Nursing, Lanzhou University, NO. 28 Yanxi Road, Lanzhou, Gansu 730000, PR China.

出版信息

Heart Lung. 2022 May-Jun;53:25-31. doi: 10.1016/j.hrtlng.2022.01.007. Epub 2022 Feb 1.

DOI:10.1016/j.hrtlng.2022.01.007

PMID:35121488

Abstract

BACKGROUND

Frailty has been reported to be significantly associated with adverse health outcomes in people with heart failure (HF).

OBJECTIVES

To explore the potential effects of frailty on unplanned readmissions and death in people with HF patients aged 18 years or older.

METHODS

342 HF patients aged 18 years or older from the heart centers of two different tertiary care hospitals located in northwest of China were enrolled between July and December 2020. Frailty was assessed by the Tilburg Frailty Indicator. The patients were followed for unplanned readmissions, and all-cause mortality at 30, 60, as well as 90 days after discharge. Multivariate cox regression models were used to analyze the effects of frailty on 90-day unplanned readmission and death in the patients with HF.

RESULTS

Frailty prevalence was 54.7% among 342 HF patients, with a mean age of 64.65 ± 11.90 years. It was found that compared to non-frailty HF patients, the frailty HF patients were older and displayed higher systolic blood pressure, longer duration of HF, more severe cognitive function, and more comorbidities (P < 0.05). On the contrary, the patients in the frail group had a higher incidence of unplanned readmission (73.1% vs. 26.9%, χ2 = 18.87, P < 0.01) and death (100% vs. 0%, χ2 = 6.94, P < 0.01) than those in the non-frail group. Multivariate cox regression analysis showed that frailty could serve as an independent risk factor for 90-day unplanned readmission (HR = 1.469, 95% CI 1.318-1.637, P < 0.01) and 90-day death (HR=2.270, 95% CI 1.091-4.726, P < 0.01) in the patients with HF.

CONCLUSION

Frailty can act as an independent predictor of unplanned readmission and death 90-day after discharge in HF patients aged 18 years or older.

摘要

背景

衰弱与心力衰竭（HF）患者的不良健康结局显著相关。

目的

探讨衰弱对 18 岁及以上 HF 患者非计划性再入院和死亡的潜在影响。

方法

2020 年 7 月至 12 月，从中国西北地区两家不同三级保健医院的心脏中心纳入 342 名 18 岁及以上的 HF 患者。采用 Tilburg 衰弱指标评估衰弱。对患者进行非计划性再入院和出院后 30、60 和 90 天的全因死亡率随访。采用多变量 cox 回归模型分析衰弱对 HF 患者 90 天非计划性再入院和死亡的影响。

结果

342 例 HF 患者中衰弱的患病率为 54.7%，平均年龄为 64.65±11.90 岁。与非衰弱 HF 患者相比，衰弱 HF 患者年龄更大，收缩压更高，HF 持续时间更长，认知功能更差，合并症更多（P<0.05）。相反，虚弱组患者非计划性再入院的发生率（73.1%比 26.9%，χ2=18.87，P<0.01）和死亡率（100%比 0%，χ2=6.94，P<0.01）均高于非虚弱组。多变量 cox 回归分析表明，衰弱是 HF 患者 90 天非计划性再入院（HR=1.469，95%CI 1.318-1.637，P<0.01）和 90 天死亡（HR=2.270，95%CI 1.091-4.726，P<0.01）的独立危险因素。