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急性心力衰竭患者的慢性便秘与预后相关。

Chronic constipation in patients with acute heart failure is related to prognosis.

作者信息

Domínguez-Rodríguez Alberto, Báez-Ferrer Néstor, Avanzas Pablo, Formica Francesco, Díaz Rocío, Abreu-González Pedro, Trujillo-Martín Elisa, Burillo-Putze Guillermo, Hernández-Vaquero Daniel

机构信息

Departamento de Medicina Interna, Universidad de La Laguna, Tenerife, España. Servicio de Cardiología, Hospital Universitario de Canarias, Tenerife, España.

Servicio de Cardiología, Hospital Universitario de Canarias, Tenerife, España.

出版信息

Emergencias. 2025 Apr;37(2):103-110. doi: 10.55633/s3me/006.2025.

Abstract

OBJECTIVE

To study whether chronic constipation (CC) in patients hospitalized for acute heart failure (AHF) is associated with short-term prognosis.

METHODS

Baseline and clinical data were prospectively collected for a cohort of patients consecutively admitted for AHF. CC was diagnosed if a patient reported having at least 2 of the following symptoms lasting at least 3 months within the past year: a) straining when emptying bowels, b) hard or lumpy stool, c) a feeling that bowels have not been fully emptied, d) a feeling of anorectal blockage, and e) fewer than 3 spontaneous bowel movements per week. We estimated crude and adjusted associations between CC and a composite outcome of 30-day mortality or readmission for AHF.

RESULTS

A total of 492 patients hospitalized for AHF were studied; 116 (23.6%) were diagnosed with CC on admission. The mean (SD) age was 64 (11) years for patients without CC and 65 (10) years for patients with CC. Patients with CC had higher prevalences of chronic kidney insufficiency, valvular heart disease, atrial fibrillation, and need for mechanical ventilation on admission. The Kaplan-Meier analyses before and after propensity score matching showed that risk for 30-day mortality or readmission for AHF was significantly greater in patients with CC (before, log-rank P .001); after, log-rank P = .046).

CONCLUSIONS

Poorer clinical outcomes were associated with CC in this cohort of patients with AHF.

摘要

目的

研究因急性心力衰竭(AHF)住院的患者中慢性便秘(CC)是否与短期预后相关。

方法

前瞻性收集连续收治的AHF患者队列的基线和临床数据。如果患者报告在过去一年内有以下至少2种症状持续至少3个月,则诊断为CC:a)排便时用力,b)大便硬或呈块状,c)感觉肠道未完全排空,d)肛门直肠堵塞感,e)每周自发排便少于3次。我们估计了CC与30天死亡率或AHF再入院的复合结局之间的粗略和校正关联。

结果

共研究了492例因AHF住院的患者;116例(23.6%)入院时被诊断为CC。无CC患者的平均(标准差)年龄为64(11)岁,CC患者为65(10)岁。CC患者慢性肾功能不全、心脏瓣膜病、心房颤动的患病率更高,入院时需要机械通气。倾向评分匹配前后的Kaplan-Meier分析显示,CC患者30天死亡率或AHF再入院的风险显著更高(匹配前,对数秩检验P<0.001);匹配后,对数秩检验P = 0.046)。

结论

在这个AHF患者队列中,较差的临床结局与CC相关。

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