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生活空间活动与老年心血管疾病患者的预后相关。

Life-Space Activities Are Associated with the Prognosis of Older Adults with Cardiovascular Disease.

作者信息

Hashimoto Kakeru, Hirashiki Akihiro, Oya Koharu, Sugioka Junpei, Tanioku Shunya, Sato Kenji, Ueda Ikue, Itoh Naoki, Kokubo Manabu, Shimizu Atsuya, Kagaya Hitoshi, Kondo Izumi

机构信息

Department of Rehabilitation, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan.

Department of Cardiology, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan.

出版信息

J Cardiovasc Dev Dis. 2022 Sep 24;9(10):323. doi: 10.3390/jcdd9100323.

Abstract

Life-space activities are a measure of daily activity level. Here, we examined the association between life-space activities and prognosis in 129 cardiovascular diseases (CVD) patients 65 years of age or older (average age, 79.2 ± 7.6 years; mean left ventricular ejection fraction, 56.7 ± 13.2%) who had been admitted to our hospital for worsening CVD. Subjects were followed, and the primary endpoints were cardiovascular hospitalization and cardiovascular death. Receiver operating characteristic analysis produced a cutoff value for life-space assessment (LSA) score for increased risk of cardiovascular hospitalization for two years of 53.0 points (sensitivity, 55.9%; specificity, 82.1%). Kaplan−Meier analysis using this cutoff value revealed that the rates of cardiovascular hospitalization and cardiovascular death were significantly higher in subjects with an LSA score below the cutoff than in those with a score above the cutoff (both p < 0.001). Cox proportional analysis revealed that low LSA score was independently associated with cardiovascular hospitalization (HR, 2.540; 95% CI, 1.135−5.680; p = 0.023) and cardiovascular death (HR, 15.223; 95% CI, 1.689−137.180; p = 0.015), even after adjusting for age, sex, left ventricular ejection fraction, and log-transformed brain natriuretic peptide level. Thus, life-space activities are associated with prognosis in older adults with CVD.

摘要

生活空间活动是日常活动水平的一种衡量指标。在此,我们研究了129例65岁及以上(平均年龄79.2±7.6岁;平均左心室射血分数56.7±13.2%)因心血管疾病(CVD)病情恶化而入住我院的患者的生活空间活动与预后之间的关联。对这些受试者进行随访,主要终点为心血管住院和心血管死亡。受试者工作特征分析得出,两年内心血管住院风险增加的生活空间评估(LSA)评分临界值为53.0分(敏感性为55.9%;特异性为82.1%)。使用该临界值进行的Kaplan-Meier分析显示,LSA评分低于临界值的受试者的心血管住院率和心血管死亡率显著高于评分高于临界值的受试者(均p<0.001)。Cox比例分析显示,即使在调整年龄、性别、左心室射血分数和经对数转换的脑钠肽水平后,低LSA评分仍与心血管住院(HR,2.540;95%CI,1.135 - 5.680;p = 0.023)和心血管死亡(HR,15.223;95%CI,1.689 - 137.180;p = 0.015)独立相关。因此,生活空间活动与老年CVD患者的预后相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21a6/9604436/ce4430141c53/jcdd-09-00323-g001.jpg

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