Brown A M, Cleland J G
MRC Clinical Research Initiative in Heart Failure, University of Glasgow, Scotland, U.K.
Eur Heart J. 1998 Jul;19(7):1063-9.
To determine the prevalence of common, serious, concomitant conditions complicating admissions with heart failure and how such conditions influence the length of hospital stay.
Data from Scottish morbidity records (SMR1) were used to determine the rate of deaths and discharges for heart failure (ICD-9 428.0, 428.9), concomitant discharge diagnoses and length of stay in 1995. 27,477 SMR1 records listing heart failure as a diagnosis were identified with heart failure in the first position in 11,560 (42%) records. 63.3% of deaths or discharges results from emergency admission. 13.2% of admissions were associated with acute myocardial infarction, 7.3% with angina or chest pain, 11.8% with chronic airways obstruction, 8.3% with chronic or acute renal failure and 5.3% had had a stroke. Length of stay including those patients who died was 7.6 days when acute myocardial infarction was the principal diagnosis but 26.3 days when stroke was the principal diagnosis.
A large proportion of deaths and discharges for heart failure are associated with conditions other than heart failure that may precipitate, contribute to or complicate admission. Treatment for heart failure that does not also seek to reduce the risk associated with common concomitant diseases may miss opportunities to reduce the overall risk of hospitalization.
确定合并心力衰竭入院时常见、严重伴随疾病的患病率，以及这些疾病如何影响住院时间。
利用苏格兰发病率记录（SMR1）数据确定1995年心力衰竭（国际疾病分类第九版428.0、428.9）的死亡和出院率、伴随出院诊断及住院时间。共识别出27477条将心力衰竭列为诊断的SMR1记录，其中11560条（42%）记录中心力衰竭排在首位。63.3%的死亡或出院是急诊入院导致的。13.2%的入院与急性心肌梗死相关，7.3%与心绞痛或胸痛相关，11.8%与慢性气道阻塞相关，8.3%与慢性或急性肾衰竭相关，5.3%曾患中风。以急性心肌梗死为主要诊断时，包括死亡患者在内的住院时间为7.6天，但以中风为主要诊断时则为26.3天。
心力衰竭的大量死亡和出院与心力衰竭以外的其他疾病相关，这些疾病可能促使、导致入院或使入院情况复杂化。不设法降低与常见伴随疾病相关风险的心力衰竭治疗可能会错失降低总体住院风险的机会。
