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慢性心力衰竭患者日常客观测量的身体活动与健康效用值和疾病严重程度的关联:一项横断面研究。

Association of objectively measured daily physical activity and health utility to disease severity in chronic heart failure patients: A cross-sectional study.

作者信息

Izawa Kazuhiro P, Kasahara Yusuke, Watanabe Satoshi, Oka Koichiro, Brubaker Peter H, Kida Keisuke, Akashi Yoshihiro J

机构信息

Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan.

Department of Rehabilitation Medicine, St. Marianna University Yokohama-city Seibu Hospital, Yokohama, Japan.

出版信息

Am Heart J Plus. 2021 Oct 7;10:100051. doi: 10.1016/j.ahjo.2021.100051. eCollection 2021 Oct.

Abstract

BACKGROUND AND AIMS

Physical activity (PA) levels are related to mortality and morbidity in patients with chronic heart failure (CHF). Health utility (HU), a very important cost-effectiveness analysis for health care and health status, is measured by several preference-based utility measures. This study aimed to evaluate the relation between PA and HU and the effect of disease severity on PA and HU in patients with CHF.

METHODS

We enrolled 226 consecutive outpatients with CHF (mean age, 57.5 years; males, 79.6%) in this retrospective cross-sectional study. Patients were divided into three groups by NYHA class for classification of disease severity. Patient characteristics, average step count in steps/day, PA energy expenditure (PAEE) in kcal/day for 7 days as assessed by accelerometer, and HU assessed by Short Form-6D were compared between the groups.

RESULTS

Average step count ( = 0.37,  < 0.01) and average PAEE ( = 0.36,  < 0.01) correlated positively with HU in all patients. Patients were classified into three groups by NYHA class: class I ( = 92), class II ( = 97), and class III ( = 37). Average step counts (7618.58, 6452.51, and 4225.63 steps/day,  < 0.001), average PAEE (244.65, 176.88, and 103.72 kcal/day,  < 0.001), and HU (0.68, 0.63, and 0.57,  < 0.001) respectively decreased with the increase in NYHA class ( < 0.001).

CONCLUSION

This study showed a significant relationship of daily PA and HU to disease severity in patients with CHF. Although causation cannot be determined from this study, these results suggest that PA and HU may provide important information related to the severity of disease in patients with CHF.

摘要

背景与目的

体力活动(PA)水平与慢性心力衰竭(CHF)患者的死亡率和发病率相关。健康效用(HU)是医疗保健和健康状况非常重要的成本效益分析指标,通过几种基于偏好的效用测量方法来衡量。本研究旨在评估PA与HU之间的关系以及疾病严重程度对CHF患者PA和HU的影响。

方法

在这项回顾性横断面研究中,我们纳入了226例连续的CHF门诊患者(平均年龄57.5岁;男性占79.6%)。根据纽约心脏协会(NYHA)分级将患者分为三组以对疾病严重程度进行分类。比较了各组之间的患者特征、每日平均步数、通过加速度计评估的7天日均PA能量消耗(PAEE,单位为千卡/天)以及通过简式-6D评估的HU。

结果

所有患者的平均步数(r = 0.37,P < 0.01)和平均PAEE(r = 0.36,P < 0.01)与HU呈正相关。根据NYHA分级将患者分为三组:I级(n = 92)、II级(n = 97)和III级(n = 37)。平均步数(分别为7618.58、6452.51和4225.63步/天,P < 0.001)、平均PAEE(分别为244.65、176.88和103.72千卡/天,P < 0.001)以及HU(分别为0.68、0.63和0.57,P < 0.001)均随NYHA分级的增加而分别降低(P < 0.001)。

结论

本研究表明CHF患者的每日PA和HU与疾病严重程度之间存在显著关系。尽管本研究无法确定因果关系,但这些结果表明PA和HU可能提供与CHF患者疾病严重程度相关的重要信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f552/10978131/821859258840/gr1.jpg

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