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|本期目录/Table of Contents|

心力衰竭患者6 949例在院30 d病死率危险因素分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第6期
页码:
748-751
栏目:
临床研究
出版日期:
2011-12-25

文章信息/Info

Title:
Risk factors for 30-day mortality in hospitalized patients with congestive heart failure
作者:
尹巧香1; 赵玉生2; 侯晓平1
1.空军总医院干部病房心内科，北京 100853；2.解放军总医院老年心血管病研究所，北京 100853
Author(s):
YIN Qiao-xiang1;  ZHAO Yu-sheng2;  HOU Xiao-ping1
1.Department of Elderly Cardiology, General Hospital of Air Force, Beijing 100853, China; 2.Institute of Geriatric Cardiology, PLA General Hospital, Beijing 100853, China
关键词:
心力衰竭; 充血性; 并发疾病; 在院病死率
Keywords:
congestive heart failure;  comorbidity;  in-hospital mortality
分类号:
R541.61
DOI:
-
文献标识码:
A
摘要:
目的:虽然心力衰竭（心衰）的治疗有了很大的进步，但心衰住院患者的在院病死率仍然很高。本项研究主要是调查影响心衰住院患者30 d在院病死率的独立危险因素。方法: 选择1993年1月1日～2007年12月31日15年间心衰住院患者6 949 (男4 344，女2 605)例，用Cox风险模型统计心衰住院患者在院病死率的独立危险因素。结果： 对心衰住院患者在院病死率有显著影响的因素是：老龄 ［HR 1.030，95%CI (1.021-1.039) P=0.000］；疾病包括冠心病、肺心病、心肌梗死、肺炎、脑血管病、消化道出血和肝硬化（P=0.000）,心肌病(P=0.006)、瓣膜性心脏病(P=0.025)、慢性阻塞型肺病(P=0.032)。Kaplan-Meier生成曲线显示共患疾病数目越多，死亡概率越大(HR 1.04, 95%CI 0.74-1.47 到HR 2.88， 95%CI 2.19-3.80,P<0.01)；本研究时段(1998-2002 vs. 1993-1997,HR 0.71 95%CI 0.55-0.93,P<0.05)；(2003-2007 vs. 1993-1997,HR 0.59 95%CI 0.46-0.76,P<0.01)。结论： 老龄、并发疾病、时段是影响心衰住院患者30 d在院病死率的独立危险因素。
Abstract:
AIM:To explore the risk factors for 30-day in-hospital mortality in congestive heart failure (CHF) patients. METHODS: A retrospective study was performed in 6949 patients (4344 males, 2605 females) from January 1, 1993 through December 31, 2007. A Cox proportional hazards model was developed to identify the independent risk factors. RESULTS: Cox analysis showed that the independent risk factors for in-hospital mortality in CHF patients were older age (HR 1.030, 95% CI 1.021-1.039, P=0.000) and comorbid diseases including coronary heart diseases, cor pulmonale, myocardial infarction, pneumonia, cerebrovascular diseases, gastrointestinal bleeding and cirrhosis of liver (P=0.000), cardiomyopathy (P=0.006), valvular heart disease (P=0.025), and chronic obstructive pulmonary disease (P=0.032). Kaplan-Meier survival curves analysis showed a higher hospital mortality rate associated with increased number of comorbidities ［hazard ratio (HR) from 1.04 95% CI 0.74-1.47 to HR 2.88 95% CI 2.19-3.80, P<0.001］ during the study period (1998-2002 vs. 1993-1997, HR 0.71 95% CI 0.55-0.93, P=0.013), (2003-2007 vs. 1993-1997, HR 0.59 95% CI 0.46-0.76, P<0.001). CONCLUSION: Older age, comorbidities and time period are all independent risk factors for 30-day in-hospital mortality in CHF patients.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2011-02-22.通讯作者：尹巧香，副主任医师，主要从事心力衰竭基础与临床、干细胞移植的研究 Email:zmyyqx-20041129@163.com
更新日期/Last Update: 2011-12-27