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印度北部三级医院收治的心力衰竭患者的临床特征、治疗模式及一年期预后

Clinical profile, treatment patterns and one-year outcome of heart failure patients admitted in tertiary care hospital of North India.

作者信息

Shah Usaid A, Rashid Aamir, Mufti Showkat A, Khan Saba, Qazi Zahid M, Masoom Injeela, Khuja Zubair A, Bukhari Immia, Kakroo Shahood A, Rather Hilal

机构信息

Department of Medicine, SKIMS, Soura, Srinagar, Jammu and Kashmir, India.

Department of Cardiology, SKIMS, Soura, Srinagar, Jammu and Kashmir, India.

出版信息

J Family Med Prim Care. 2024 Aug;13(8):3225-3230. doi: 10.4103/jfmpc.jfmpc_1868_23. Epub 2024 Jul 26.

Abstract

INTRODUCTION

Because of wide heterogeneity in the epidemiology of heart failure among different populations, it is imperative to establish population-specific databases.

AIMS AND OBJECTIVES

To describe the clinical profile, treatment patterns, and outcomes of heart failure patients admitted to our tertiary care hospital.

MATERIAL AND METHODS

The study was a prospective observational study conducted over two years at our tertiary care hospital. It included patients admitted with acute and acute-on-chronic heart failure.

RESULTS

We recruited 264 patients. Mean age of the study population was 57.8 ± 15.14 years. Males were 157 (59.5%). Dilated cardiomyopathy was the most common cause followed by ischemic heart disease. Most common risk factors were hypertension, tobacco use, anemia, and diabetes. Heart failure with reduced ejection fraction was present in 154 (62%) patients. Acute de novo heart failure was present in 91 (34.5%) patients. The most common precipitant for heart failure exacerbation was infection, followed by ischemic causes and non-adherence to drugs. The mean duration of hospital stay was 7.5 ± 3.1 days. The in-hospital mortality was 8.7%, and cumulative six-month and one-year mortality was 23% and 28%, respectively. In multivariate analysis, renal failure, readmission, and not being on guideline-directed medical treatment were significant predictors of mortality.

CONCLUSION

Our patients were younger, predominantly males, with dilated and ischemic cardiomyopathy as commonest etiology. Hypertension and tobacco smoking were most common risk factors, with infections as most common precipitants. Only one-third of patients were on guideline-directed medical therapy. The one-year mortality was 28% and was higher in those without guideline-directed medical therapy.

摘要

引言

由于不同人群中心力衰竭的流行病学存在广泛异质性,因此建立针对特定人群的数据库势在必行。

目的

描述入住我们三级医院的心力衰竭患者的临床特征、治疗模式和结局。

材料与方法

本研究是在我们三级医院进行的一项为期两年的前瞻性观察性研究。纳入了急性心力衰竭和急性慢性心力衰竭患者。

结果

我们招募了264名患者。研究人群的平均年龄为57.8±15.14岁。男性有157名(59.5%)。扩张型心肌病是最常见的病因,其次是缺血性心脏病。最常见的危险因素是高血压、吸烟、贫血和糖尿病。射血分数降低的心力衰竭患者有154名(62%)。急性新发心力衰竭患者有91名(34.5%)。心力衰竭加重最常见的诱因是感染,其次是缺血性病因和不遵医嘱用药。平均住院时间为7.5±3.1天。住院死亡率为8.7%,累积6个月和1年死亡率分别为23%和28%。多因素分析显示,肾衰竭、再次入院和未接受指南指导的药物治疗是死亡率的重要预测因素。

结论

我们的患者较年轻,以男性为主,扩张型和缺血性心肌病是最常见的病因。高血压和吸烟是最常见的危险因素,感染是最常见的诱因。只有三分之一的患者接受了指南指导的药物治疗。1年死亡率为28%,未接受指南指导药物治疗的患者死亡率更高。

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