老年心力衰竭患者出院后2年预后及影响因素

发布时间：2018-03-31 12:20

  本文选题：心力衰竭　切入点：再住院率　出处：《临床心血管病杂志》2017年12期

【摘要】：目的:分析老年心力衰竭患者出院后2年内的预后状况并探索影响其生存的因素。方法:随访观察146例老年心力衰竭患者出院后2年内再住院或死亡等临床资料,平均随访约15个月。分析患者预后状况,采用多因素Cox回归模型分析影响预后的因素。结果:146例患者出院后3、6、9、12、15、18、21、24个月的因心力衰竭再住院率分别为3.4%、10.9%、17.1%、19.2%、22.6%、26.0%、30.1%、35.6%;病死率分别为1.4%、2.7%、3.4%、6.8%、9.6%、12.3%、15.8%、20.5%;Cox回归分析显示,年龄75岁的患者发生再住院或死亡的危险性是≤75岁的2.353倍;氨基末端B型脑钠肽前体(NT-proBNP)1 000ng/L的患者发生危险性是NT-proBNP≤1 000ng/L的2.347倍;左室射血分数(LVEF)≤0.5%的患者发生危险性是LVEF0.5%的2.105倍;血红蛋白浓度≤130g/L的患者发生危险性是血红蛋白浓度130g/L的1.853倍;不规律服用β-受体阻滞剂的患者发生危险性是规律服用β-受体阻滞剂的1.961倍;不规律服用利尿剂的患者发生危险性是规律服用利尿剂的1.49倍。结论:老年心力衰竭患者2年内的累积再住院及病死率分别为35.6%、20.5%。年龄、NT-proBNP、LVEF、血红蛋白浓度、β-受体阻滞剂、利尿剂是影响老年心力衰竭患者2年内生存的主要因素。
[Abstract]:Objective: to analyze the prognosis of elderly patients with heart failure within 2 years after discharge and to explore the factors influencing their survival. Methods: 146 elderly patients with heart failure were followed up to observe the clinical data of re-hospitalization or death within 2 years after discharge. The mean follow-up was about 15 months. The multivariate Cox regression model was used to analyze the prognostic factors. Results in 20. 5% patients with heart failure and 20. 5%, 20. 5% had a mortality rate of 2. 4% 2.73.46.86.86% and 20. 5%, respectively, for 24 months. The average readmission rate for 24 months was 3. 4% 10.9% 17. 1% and 19. 2 0% 20. 6%. The mortality rate was 1. 4% 2.73.46.86.89.6% and 12. 315.815.815.815.5x, respectively. The risk of rehospitalization or death in patients aged 75 years was 2.353 times higher than that in patients aged 鈮，

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