ICES, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
Vanderbilt University Medical Center, Nashville, TN, USA.
Eur J Heart Fail. 2022 Jun;24(6):1020-1029. doi: 10.1002/ejhf.2508. Epub 2022 May 12.
Recovery of well-being after hospitalisation for acute heart failure (AHF) is a measure of the success of interventions and the quality of care but has rarely been quantified. Accordingly, we measured health status after discharge in an international registry (REPORT-HF) of AHF.
The analysis included 4606 patients with AHF who survived to hospital discharge, had known vital status at 6 months, and were enrolled in the United States of America, Russian Federation, or Western Europe, where the Kansas City Cardiomyopathy Questionnaire (KCCQ) was administered. Median age was 69 years (quartiles 59-78), 40% were women, and 34% had a left ventricular ejection fraction (LVEF) <40%, and 12% patients died by 6 months. Of 2475 patients with a follow-up KCCQ, 28% were 'alive and well' (KCCQ >75), while 43% had poor health status (KCCQ ≤50). Being 'alive and well' was associated with new-onset AHF, LVEF <40%, younger age, higher baseline KCCQ, country, and race. Associations were similar for increasing health status, with the exception of country and addition of comorbidities.
In this international global registry, health status recovery after AHF hospitalisation was highly variable. Those with the best health status at 6 months were younger, had new-onset heart failure, and higher baseline KCCQ; nearly one-third of survivors were 'alive and well'. Investigating reasons for changes in KCCQ after hospitalisation might identify new therapeutic targets to improve patient-centred outcomes.
急性心力衰竭（AHF）住院后恢复健康是干预措施成功和护理质量的衡量标准，但很少有量化的指标。因此，我们在急性心力衰竭国际注册研究（REPORT-HF）中测量了出院后的健康状况。
该分析纳入了 4606 例存活至出院、6 个月时已知生存状态且在美国、俄罗斯或西欧注册的 AHF 患者，这些地区均使用堪萨斯城心肌病问卷（KCCQ）进行评估。患者的中位年龄为 69 岁（四分位数范围 59-78 岁），40%为女性，34%左心室射血分数（LVEF）<40%，12%的患者在 6 个月时死亡。在 2475 例有随访 KCCQ 的患者中，28%为“存活且状况良好”（KCCQ>75），而 43%健康状况较差（KCCQ≤50）。“存活且状况良好”与新发 AHF、LVEF<40%、年龄较小、基线 KCCQ 较高、国家和种族有关。随着健康状况的改善，相关性相似，但国家和合并症除外。
在这项国际全球注册研究中，AHF 住院后健康状况的恢复具有高度的可变性。6 个月时健康状况最佳的患者更年轻、新发心力衰竭和基线 KCCQ 更高；近三分之一的幸存者“存活且状况良好”。研究住院后 KCCQ 变化的原因可能会发现改善以患者为中心的治疗目标的新治疗靶点。
