内在能力对老年心血管疾病患者5年死亡率的影响。
Impact of Intrinsic Capacity on 5-year Mortality of Older Patients With Cardiovascular Disease.
作者信息
Wan Yuhao, Li Wenzheng, Liu Junpeng, Chai Ke, Wang Hua, Yang Jiefu
机构信息
Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, 100730 Beijing, China.
Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, 100730 Beijing, China.
出版信息
Rev Cardiovasc Med. 2025 Aug 28;26(8):37477. doi: 10.31083/RCM37477. eCollection 2025 Aug.
BACKGROUND
Intrinsic capacity (IC) is defined as the combination of all physical and mental (including psychosocial) capacities that an individual can rely on at any given time. Previous studies have shown that a decline in IC is linked to an increased mortality rate. Thus, this study aimed to evaluate the impact of IC on the 5-year mortality of older people with cardiovascular disease.
METHODS
This was a prospective cohort study conducted at a tertiary-level A hospital in China between September 2018 and April 2019, with a follow-up period of 5 years. We applied a proposed IC score to assess the baseline IC of each participant. The primary clinical outcome was 5-year all-cause mortality.
RESULTS
A total of 524 older patients (mean age, 75.2 ± 6.5 years; 51.7% men) were enrolled from the cardiology ward. A total of 86 patients (16.5%) experienced all-cause mortality over the 5-year follow-up period. Compared with the survival group, patients in the mortality group were older (81.1 ± 5.7 vs. 74.0 ± 6.0; < 0.01), showed a higher male proportion (61.6% vs. 49.8%; = 0.04), had a lower intrinsic score [7.0 (6.0, 8.0) vs. 8.0 (7.0, 9.0); < 0.01], and a higher prevalence rates of atrial fibrillation or atrial flutter (34.9% vs. 20.1%; < 0.01), heart failure (44.2% vs.11.2%; < 0.01), diabetes (48.8% vs. 33.1%; < 0.01), and chronic kidney disease (19.8% vs. 4.3%; < 0.01). After adjusting for covariates, multivariate Cox regression showed that the IC score was associated with a lower hazard ratio of 5-year all-cause mortality (hazard ratio (HR) = 0.79, 95% confidence interval (CI): 0.69-0.92, < 0.01).
CONCLUSIONS
Among these older aged patients with cardiovascular disease, the IC score is independently associated with 5-year all-cause mortality, with a lower IC score indicating a poorer prognosis.
CLINICAL TRIAL REGISTRATION
ChiCTR1800017204; date of registration: 07/18/2018. URL: https://www.chictr.org.cn/showproj.html?proj=28931.
背景
内在能力（IC）被定义为个体在任何给定时间都可以依赖的所有身体和心理（包括社会心理）能力的组合。先前的研究表明，IC的下降与死亡率增加有关。因此，本研究旨在评估IC对老年心血管疾病患者5年死亡率的影响。
方法
这是一项前瞻性队列研究，于2018年9月至2019年4月在中国一家三级甲等医院进行，随访期为5年。我们应用了一个提议的IC评分来评估每个参与者的基线IC。主要临床结局是5年全因死亡率。
结果
从心内科病房共纳入524例老年患者（平均年龄75.2±6.5岁；男性占51.7%）。在5年的随访期内，共有86例患者（16.5%）发生全因死亡。与存活组相比，死亡组患者年龄更大（81.1±5.7岁对74.0±6.0岁；P<0.01），男性比例更高（61.6%对49.8%；P = 0.04），内在评分更低[7.0（6.0，8.0）对8.0（7.0，9.0）；P<0.01]，房颤或房扑患病率更高（34.9%对20.1%；P<0.01）、心力衰竭患病率更高（44.2%对11.2%；P<0.01）、糖尿病患病率更高（48.8%对33.1%；P<0.01）以及慢性肾脏病患病率更高（19.8%对4.3%；P<0.01）。在对协变量进行调整后，多因素Cox回归显示IC评分与5年全因死亡率的较低风险比相关（风险比（HR）=0.79，95%置信区间（CI）：0.69 - 0.92，P<0.01）。
结论
在这些老年心血管疾病患者中，IC评分与5年全因死亡率独立相关，IC评分越低表明预后越差。
临床试验注册
ChiCTR18000应改为ChiCTR1800017204；注册日期：2018年7月18日。网址：https://www.chictr.org.cn/showproj.html?proj=28931 。 （注：原文中“ChiCTR18000应改为ChiCTR1800017204”，此为对原文错误表述的修正，实际翻译时应按正确内容翻译）
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