尹巧香, 赵玉生, 侯晓平. 心力衰竭患者6 949例在院30 d病死率危险因素分析[J]. 心脏杂志, 2011, 23(6): 748-751.
    引用本文: 尹巧香, 赵玉生, 侯晓平. 心力衰竭患者6 949例在院30 d病死率危险因素分析[J]. 心脏杂志, 2011, 23(6): 748-751.
    shu
    Risk factors for 30-day mortality in hospitalized patients with congestive heart failure[J]. Chinese Heart Journal, 2011, 23(6): 748-751.
    Citation: Risk factors for 30-day mortality in hospitalized patients with congestive heart failure[J]. Chinese Heart Journal, 2011, 23(6): 748-751.
    shu

    心力衰竭患者6 949例在院30 d病死率危险因素分析

    Risk factors for 30-day mortality in hospitalized patients with congestive heart failure

      摘要
    • 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.

       

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