Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
Department of Pharmacy, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
Clin Interv Aging. 2024 Sep 6;19:1519-1528. doi: 10.2147/CIA.S464044. eCollection 2024.
To evaluate the impact of adverse health conditions, including multimorbidity, frailty, malnutrition, cognitive impairment, and polypharmacy, on clinical outcomes in older people with atrial fibrillation (AF).
This prospective cohort study focused on patients aged 65 years and older with AF. They were admitted to the hospital between September 2018 and April 2019 and followed up for 1 year. We evaluated these participants for adverse health conditions including multimorbidity, frailty, malnutrition, cognitive impairment, and polypharmacy. The primary clinical outcome measured was a combination of all-cause mortality or rehospitalization.
197 older patients (≥65 years) with AF (mean age, 77.5±7.1 years; 57.4% men) were enrolled. During 1-year follow-up, Primary endpoint events (all-cause mortality or rehospitalization) occurred in 82 patients (41.6%). Compared with the non-event group, the Charlson comorbidity index (CCI) was higher (2.5±1.9 vs 1.7±1.3, p=0.004), more heart failure (32.9% vs 17.4%, p=0.01) and chronic kidney disease (17.1% vs 7.0%, p=0.03), with lower systolic blood pressure (125.3±18.3 mmHg vs 132±17.9 mmHg, p=0.005) in the event group. On multivariate Cox regression showed that the CCI was associated with a higher odds ratio of the composite outcome of all-cause mortality and rehospitalization (HR: 1.26; 95% CI: 1.02-1.56, p=0.03). Other adverse health conditions showed no significant association with the composite outcome of all-cause mortality and rehospitalization.
Among adverse health conditions in older people with AF, multimorbidity appears to be a significant determinant of adverse clinical outcomes.
ChiCTR1800017204; date of registration: 07/18/2018.
评估多种不良健康状况（包括多种合并症、衰弱、营养不良、认知障碍和多种药物治疗）对老年心房颤动（AF）患者的临床结局的影响。
本前瞻性队列研究聚焦于年龄在 65 岁及以上的 AF 患者。他们于 2018 年 9 月至 2019 年 4 月期间住院，并随访 1 年。我们评估了这些参与者的多种不良健康状况，包括多种合并症、衰弱、营养不良、认知障碍和多种药物治疗。主要临床终点测量指标是全因死亡率或再住院的综合结果。
共纳入 197 名（≥65 岁）老年 AF 患者（平均年龄 77.5±7.1 岁；57.4%为男性）。在 1 年随访期间，有 82 名患者（41.6%）发生主要终点事件（全因死亡率或再住院）。与非事件组相比，Charlson 合并症指数（CCI）更高（2.5±1.9 比 1.7±1.3，p=0.004），心力衰竭（32.9%比 17.4%，p=0.01）和慢性肾脏病（17.1%比 7.0%，p=0.03）更多，而收缩压更低（125.3±18.3mmHg 比 132±17.9mmHg，p=0.005）。多变量 Cox 回归显示，CCI 与全因死亡率和再住院的复合结局的更高比值相关（HR：1.26；95%CI：1.02-1.56，p=0.03）。其他不良健康状况与全因死亡率和再住院的复合结局无显著相关性。
在老年 AF 患者的多种不良健康状况中，多种合并症似乎是不良临床结局的重要决定因素。
ChiCTR1800017204；注册日期：2018 年 7 月 18 日。
