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心力衰竭与肾功能恶化:城市少数民族人群中的患病率、危险因素及其对再次入院的影响

Heart Failure and Worsening Renal Function: Prevalence, Risk Factors, and Impact on Hospital Readmissions in an Urban Minority Population.

作者信息

AlShammari Asmaa, Magdits Mariel, Majdalani Rosemarie, Devarajan Sriraman, Hughes Anna, McCann Lily, Ionescu Natalia, Raiszadeh Farbod

机构信息

Kuwait's Foundation for the Advancement of Sciences, Kuwait City 12081, Kuwait.

The Institute of Human Nutrition, Columbia University Irving Medical Center, New York, NY 10032, USA.

出版信息

J Clin Med. 2025 Jan 28;14(3):877. doi: 10.3390/jcm14030877.

Abstract

: Heart failure (HF) often leads to worsening renal function (WRF), negatively impacting patient outcomes. This study aims to examine the incidence of WRF in HF patients, identify its risk factors, and assess its effect on readmissions. : This retrospective analysis included 297 HF patients admitted to Harlem Hospital Center between January 2019 and December 2021. WRF incidence and its association with risk factors, hospital stays, and readmissions were analyzed. Data on age, type 2 diabetes, chronic kidney disease, high-dose furosemide use, and biomarkers (ProBNP, troponin T, creatinine) were collected. A risk-scoring system was developed to identify patients at higher risk for WRF. : WRF occurred in 27% of patients, with a significant correlation to longer hospital stays and lower cardiology follow-up adherence. Risk factors for WRF included older age, type 2 diabetes, chronic kidney disease, high-dose furosemide, and elevated ProBNP, troponin T, and creatinine levels. The risk scoring system revealed that patients scoring 6 or higher were four times more likely to develop WRF. Interestingly, WRF did not increase 30-day readmission rates. : This study highlights the high incidence of WRF among HF patients, its impact on hospital stays and follow-up adherence, and the utility of a risk-scoring system to identify vulnerable patients. The findings offer valuable insights into improving care in minority-serving hospitals and provide a foundation for future research on WRF in HF patients.

摘要

心力衰竭(HF)常导致肾功能恶化(WRF),对患者预后产生负面影响。本研究旨在调查HF患者中WRF的发生率,确定其危险因素,并评估其对再入院率的影响。

这项回顾性分析纳入了2019年1月至2021年12月期间入住哈莱姆医院中心的297例HF患者。分析了WRF的发生率及其与危险因素、住院时间和再入院率的关联。收集了有关年龄、2型糖尿病、慢性肾脏病、大剂量呋塞米使用情况以及生物标志物(ProBNP、肌钙蛋白T、肌酐)的数据。开发了一种风险评分系统以识别WRF风险较高的患者。

27%的患者发生了WRF,这与更长的住院时间和更低的心脏病学随访依从性显著相关。WRF的危险因素包括老年、2型糖尿病、慢性肾脏病、大剂量呋塞米以及ProBNP、肌钙蛋白T和肌酐水平升高。风险评分系统显示,得分6分或更高的患者发生WRF的可能性高出四倍。有趣的是,WRF并未增加30天再入院率。

本研究强调了HF患者中WRF的高发生率、其对住院时间和随访依从性的影响,以及风险评分系统在识别易患患者方面的效用。这些发现为改善为少数族裔服务的医院的护理提供了有价值的见解,并为未来关于HF患者WRF的研究奠定了基础。

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