年龄对充血性心力衰竭住院患者短期和长期死亡率的影响

来源 :世界核心医学期刊文摘(心脏病学分册) | 被引量 : 0次 | 上传用户:memory_prince
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To describe the association between age and risk factors in patients hospitali sed with congestive heart failure(CHF) and to determine the effect of age on mor tality. Consecutive patients admitted to 34 hospitals with CHF during a period o f 2 years were registered. Mean age was 71.7±10.2 years, 60%were male and 63% were in NYHA class III IV. Moderate to severe left ventricular(LV) systolic dysfunction was present in 41%. Short and long term survival status was obta ined after 30 days and 5-8 years, respectively. Older patients less frequently had LV systolic dysfunction, were under treated with ACE inhibitors and were mo re often female. The prevalence of hypertension, diabetes and ischaemic heart di sease increased with age, until the oldest age group (>80 years). Age was an ind ependent predictor of short term mortality (risk ratio (RR) per 10-year increa se was 1.23(95%CI 1.04-1.47)). Advancing age significantly increased long ter m mortality (RR 1.55 (1.50-1.61)). Age interacted with the LV ejection fraction (P=0.003). In patients with LV systolic dysfunction, the RR per 10-year increa se was 1.29(1.19-1.39) whereas in patients with preserved systolic function the RR was 1.57(1.43-1.72, multivariate analyses). The clinical characteristics of CHF patients vary considerably with age. Elderly patients hospitalised with CHF face a very grave prognosis, particularly if their heart failure symptoms are c aused by LV systolic dysfunction. To describe the association between age and risk factors in patients hospitali sed with congestive heart failure (CHF) and to determine the effect of age on mor tality. Consecutive patients admitted to 34 hospitals with CHF during a period of 2 years were registered. was 71.7 ± 10.2 years, 60% were male and 63% were in NYHA class III IV. Moderate to severe left ventricular (LV) systolic dysfunction was present in 41%. Short and long term survival status was obtained after 30 days and 5 -8 years, respectively. Older patients less frequently had LV systolic dysfunction, were under treated with ACE inhibitors and were mo re often female. The prevalence of hypertension, diabetes and ischaemic heart diase with age, until the oldest age group (> 80 years). Age was an indpendent predictor of short term mortality (risk ratio (RR) per 10-year increa was 1.23 (95% CI 1.04-1.47)). Advancing age significantly increased long term mortality (RR 1.55 1.50-1.61)). Age interacted with the LV ejection fraction (P = 0.003). In patients with LV systolic dysfunction, the RR per 10-year increa was 1.29 (1.19-1.39) while in patients with preserved systolic function the RR was 1.57 (1.43-1.72, multivariate analyzes the clinical characteristics of CHF patients vary considerably with age. Elderly patients hospitalized with CHF face a very grave prognosis, particularly if their heart failure symptoms are c aused by LV systolic dysfunction.
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