Department of Internal Medicine, Centro Hospitalar Universitário de Santo António, EPE, Porto, Portugal; Unidade Multidisciplinar de Investigação Biomédica (UMIB), ICBAS - Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal; ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.
Department of Internal Medicine, Centro Hospitalar Universitário de Santo António, EPE, Porto, Portugal.
Rev Port Cardiol. 2023 Jun;42(6):505-513. doi: 10.1016/j.repc.2022.07.017. Epub 2023 Mar 7.
One-year mortality after hospitalization for heart failure (HF) is high. This study aims to identify predictive factors of one-year mortality.
This is a retrospective, single-center and observational study. All patients hospitalized for acute HF during one year were enrolled.
A total of 429 patients were enrolled, mean age of 79 years. The in-hospital and one-year all-cause mortality rates were 7.9% and 34.3%, respectively. In the univariable analysis, the factors significantly associated with higher one-year mortality risk were: age ≥80 years (odds ratio (OR)=2.05, 95% confidence interval (CI) 1.35-3.11, p=0.001); active cancer (OR=2.93, 95% CI 1.36-6.32, p=0.008); dementia (OR=2.84, 95% CI 1.81-4.47, p<0.001); functional dependency (OR=2.63, 95% CI 1.65-4.19, p<0.001); atrial fibrillation (OR=1.86, 95% CI 1.24-2.80, p=0.004); higher creatinine (OR=2.03, 95% CI 1.29-3.21, p=0.002), urea (OR=2.92, 95% CI 1.95-4.36, p<0.001) and red cell distribution width (RDW; 4thQ OR=5.59, 95% CI 3.03-10.32, p=0.001); and lower hematocrit (OR=0.94, 95% CI 0.91-0.97, p<0.001), hemoglobin (OR=0.83, 95% CI 0.75-0.92, p<0.001) and platelet distribution width (PDW; OR=0.89, 95% CI 0.82-0.97, p=0.005). In the multivariable analysis, the independent predictors of higher one-year mortality risk were: age ≥80 years (OR=2.05, 95% CI 1.21-3.48); active cancer (OR=2.70, 95% CI 1.03-7.01); dementia (OR=2.69, 95% CI 1.53-4.74); higher urea (OR=2.97, 95% CI 1.84-4.80) and RDW (4thQ OR=5.24, 95% CI 2.55-10.76); and lower PDW (OR=0.88, 95% CI 0.80-0.97).
Active cancer, dementia, and high values for urea and RDW at admission are predictors of one-year mortality in patients hospitalized for HF. These variables are readily available at admission and can support the clinical management of HF patients.
心力衰竭（HF）住院患者的一年死亡率很高。本研究旨在确定一年死亡率的预测因素。
这是一项回顾性、单中心和观察性研究。纳入了一年内因急性 HF 住院的所有患者。
共纳入 429 例患者，平均年龄为 79 岁。院内和一年全因死亡率分别为 7.9%和 34.3%。单变量分析中，与较高一年死亡率风险显著相关的因素为：年龄≥80 岁（比值比（OR）=2.05，95%置信区间（CI）1.35-3.11，p=0.001）；活动性癌症（OR=2.93，95%CI 1.36-6.32，p=0.008）；痴呆（OR=2.84，95%CI 1.81-4.47，p<0.001）；功能依赖（OR=2.63，95%CI 1.65-4.19，p<0.001）；心房颤动（OR=1.86，95%CI 1.24-2.80，p=0.004）；较高的肌酐（OR=2.03，95%CI 1.29-3.21，p=0.002）、尿素（OR=2.92，95%CI 1.95-4.36，p<0.001）和红细胞分布宽度（RDW；第 4 四分位数 OR=5.59，95%CI 3.03-10.32，p=0.001）；以及较低的血细胞比容（OR=0.94，95%CI 0.91-0.97，p<0.001）、血红蛋白（OR=0.83，95%CI 0.75-0.92，p<0.001）和血小板分布宽度（PDW；OR=0.89，95%CI 0.82-0.97，p=0.005）。多变量分析中，一年死亡率较高的独立预测因素为：年龄≥80 岁（OR=2.05，95%CI 1.21-3.48）；活动性癌症（OR=2.70，95%CI 1.03-7.01）；痴呆（OR=2.69，95%CI 1.53-4.74）；较高的尿素（OR=2.97，95%CI 1.84-4.80）和 RDW（第 4 四分位数 OR=5.24，95%CI 2.55-10.76）；以及较低的 PDW（OR=0.88，95%CI 0.80-0.97）。
活动性癌症、痴呆以及入院时尿素和 RDW 值升高是 HF 住院患者一年死亡率的预测因素。这些变量在入院时即可获得，可支持 HF 患者的临床管理。
