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术前衰弱对心脏植入式电子设备植入术后再入院的影响。

The impacts of preoperative frailty on readmission after cardiac implantable electrical device implantation.

机构信息

Department of Rehabilitation, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.

Graduate School of Niigata University of Health and Welfare, Niigata, Niigata, Japan.

出版信息

PLoS One. 2022 Nov 3;17(11):e0277115. doi: 10.1371/journal.pone.0277115. eCollection 2022.

Abstract

Cardiac implantable electrical devices (CIED) such as pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapies are generally recommended for older patients and those with severe heart failure (HF). However, there is currently a lack of evidence on the relationship between frailty and readmission rates among patients with CIED. This study investigated whether preoperative frailty influenced readmission rates among patients with CIED over a one-year period following implantation. The study retrospectively analyzed 101 patients who underwent CIED implantations. To compare frailty-based differences in their characteristics and readmission rates, these participants were categorized into frailty and non-frailty groups via the modified frailty index (mFI). The frailty group had a significantly higher readmission rate than the non-frailty group (non-frailty group vs. frailty group = 1 vs. 8 patients: P < 0.05). Further, a multivariate analysis showed that frailty was a significant readmission factor. Based on individual analyses with/without histories of HF, the readmission rate also tended to be higher among individuals considered frail via the mFI (readmission rate in HF patients: non-frailty group vs. frailty group = 1 vs. 5 patients: P = 0.65; non-HF patients: non-frailty group vs. frailty group = 0 vs. 3 patients: P = 0.01). Participants with preoperative frailty showed higher readmission rates within a one-year period following implantation compared to those without preoperative frailty. This tendency was consistent regardless of HF history. The mFI may thus help predict readmission among patients with CIED.

摘要

心脏植入式电子设备(CIED),如起搏器、植入式心律转复除颤器和心脏再同步治疗,通常推荐用于老年患者和严重心力衰竭(HF)患者。然而,目前关于 CIED 患者衰弱与再入院率之间的关系缺乏证据。本研究调查了术前衰弱是否会影响植入后一年内 CIED 患者的再入院率。该研究回顾性分析了 101 名接受 CIED 植入的患者。为了比较基于虚弱的特征和再入院率的差异,这些参与者通过改良虚弱指数(mFI)分为虚弱组和非虚弱组。虚弱组的再入院率明显高于非虚弱组(非虚弱组与虚弱组=1 比 8 例:P<0.05)。此外,多变量分析显示虚弱是再入院的一个重要因素。根据有无 HF 病史的个体分析,mFI 评估为虚弱的个体的再入院率也较高(HF 患者的再入院率:非虚弱组与虚弱组=1 比 5 例:P=0.65;非 HF 患者:非虚弱组与虚弱组=0 比 3 例:P=0.01)。与术前无衰弱的患者相比,术前衰弱的患者在植入后一年内的再入院率更高。这种趋势与 HF 病史无关。因此,mFI 可能有助于预测 CIED 患者的再入院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e30e/9632810/65a3f149eaf9/pone.0277115.g001.jpg

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