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心脏再同步治疗患者住院时间相关差异及长期预后:一项倾向评分匹配队列研究

Length of Hospitalization-Related Differences and Associated Long-Term Prognosis of Patients with Cardiac Resynchronization Therapy: A Propensity Score-Matched Cohort.

作者信息

Yu Yu, Huang Hao, Cheng Sijing, Deng Yu, Cai Chi, Gu Min, Chen Xuhua, Niu Hongxia, Hua Wei

机构信息

Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

出版信息

J Cardiovasc Dev Dis. 2022 Oct 15;9(10):354. doi: 10.3390/jcdd9100354.

Abstract

Previous studies indicated that prolonged lengths of hospitalization (LOH) during cardiac resynchronization therapy (CRT) implantation are associated with poorer physical status and higher in-hospital mortality. However, evidence on the impact of LOH on the long-term prognosis of CRT patients is limited. The purpose of this study was to assess LOH-related prognostic differences in CRT patients. In the propensity score-matched cohort, patients with standard LOH (≤7 days, n = 172) were compared with those with prolonged LOH (>7 days, n = 172) for cardiac function and study outcomes during follow-up. The study outcomes were all-cause death and heart failure (HF) hospitalization. In addition, cardiac function and changes in cardiac function at the follow-up period were used for comparison. At a mean follow-up of 3.36 years, patients with prolonged LOH, as compared with those with standard LOH, were associated with a significantly higher risk of all-cause death (hazard ratio [HR] 1.87, 95% confidence interval [CI] 1.18−2.96, p = 0.007), and a higher risk of HF hospitalization (HR 1.68, 95% CI 1.08−2.63, p = 0.023). Moreover, patients with standard LOH had a more significant improvement in cardiac function and a pronounced reduction in QRS duration during follow-up than those with prolonged LOH. LOH-associated differences were found in the long-term prognosis of CRT patients. Patients with prolonged LOH had a worse prognosis than those with standard LOH.

摘要

先前的研究表明,心脏再同步治疗(CRT)植入期间住院时间延长(LOH)与身体状况较差和院内死亡率较高相关。然而,关于LOH对CRT患者长期预后影响的证据有限。本研究的目的是评估CRT患者中与LOH相关的预后差异。在倾向评分匹配队列中,比较了标准LOH(≤7天,n = 172)患者与延长LOH(>7天,n = 172)患者在随访期间的心脏功能和研究结局。研究结局为全因死亡和心力衰竭(HF)住院。此外,还比较了随访期间的心脏功能及心脏功能变化。在平均3.36年的随访中,与标准LOH患者相比,延长LOH患者的全因死亡风险显著更高(风险比[HR] 1.87,95%置信区间[CI] 1.18−2.96,p = 0.007),HF住院风险也更高(HR 1.68,95% CI 1.08−2.63,p = 0.023)。此外,与延长LOH的患者相比,标准LOH患者在随访期间心脏功能改善更显著,QRS时限缩短更明显。在CRT患者的长期预后中发现了与LOH相关的差异。延长LOH的患者预后比标准LOH的患者更差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c10f/9604508/e0a6d1a02213/jcdd-09-00354-g001.jpg

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