Jaagosild P, Dawson N V, Thomas C, Wenger N S, Tsevat J, Knaus W A, Califf R M, Goldman L, Vidaillet H, Connors A F
Department of Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109-1998, USA.
Arch Intern Med. 1998 May 25;158(10):1081-9. doi: 10.1001/archinte.158.10.1081.
Congestive heart failure (CHF) is a common disease with high health care costs and high mortality rates. Knowledge of the health-related quality of life outcomes of CHF may guide decision making and be useful in assessing new therapies for this population.
A prospective cohort study was conducted involving 1390 adult patients hospitalized with an acute exacerbation of severe CHF (New York Heart Association class III-IV). Demographic data and health-related quality of life were determined by interview; physiologic status and cost and intensity of care were determined from hospital charts.
The median (25th, 75th percentiles) age of patients was 68.0 (58.2, 76.9) years; 61.7% were male. Survival was 93.4% at discharge from the index hospitalization, 72.9% at 180 days, and 61.5% at 1 year. Of patients interviewed at 180 days, the median health rating on a scale of 0 to 100 (0 indicates death; 100, excellent health) was 60 (interquartile range, 50-80), and 59.7% were independent in their activities of daily living. Overall quality of life was reported to be good, very good, or excellent in 58.2% at 180 days. Patients with worse functional capacity were more likely to die. Health perceptions among the patients with available interview data improved at 60 and 180 days after acute exacerbation of severe CHF.
Patients hospitalized for acute exacerbation of severe CHF have a generally poor 6-month survival, but survivors retain relatively good functional status and have good health perceptions. Furthermore, health perceptions improve after the acute exacerbation.
充血性心力衰竭（CHF）是一种常见疾病，医疗成本高且死亡率高。了解CHF患者与健康相关的生活质量结果可能有助于指导决策，并有助于评估针对该人群的新疗法。
进行了一项前瞻性队列研究，纳入1390例因重度CHF急性加重（纽约心脏协会III-IV级）住院的成年患者。通过访谈确定人口统计学数据和与健康相关的生活质量；从医院病历中确定生理状态、护理成本和护理强度。
患者的年龄中位数（第25、75百分位数）为68.0（58.2，76.9）岁；61.7%为男性。首次住院出院时的生存率为93.4%，180天时为72.9%，1年时为61.5%。在180天时接受访谈的患者中，0至100分（0表示死亡；100表示健康状况极佳）的健康评分中位数为60（四分位间距，50-80），59.7%的患者日常生活活动能够自理。据报告，180天时58.2%的患者总体生活质量为良好、非常好或极佳。功能能力较差的患者死亡可能性更大。在有访谈数据的患者中，重度CHF急性加重后60天和180天时的健康认知有所改善。
因重度CHF急性加重住院的患者6个月生存率普遍较差，但幸存者保留了相对良好的功能状态且健康认知良好。此外，急性加重后健康认知有所改善。
