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在美国四个社区 (2005-2014) 住院患者和急性心力衰竭患者的存活率趋势:ARIC研究社区监测
Patricia P Chang1, Lisa M Wruck2, Eyal Shahar3
1Departments of Medicine (P.P.C., J.S.R.) patricia_chang@med.unc.edu.
Circulation
|March 10, 2018
概括
从2005年至2014年,急性脱补充性心力衰竭 (ADHF) 的住院病例增加,主要是由于HFpEF. 一年生存率仍然很低,但黑人男性和女性的生存率有所提高.
科学领域:
- 心脏病学
- 公共卫生
- 流行病学
背景情况:
- 急性不补偿性心力衰竭 (ADHF) 的趋势在不同种族和性别的人群中可能有显著差异.
- 了解这些社区趋势对于有针对性的公共卫生干预至关重要.
研究的目的:
- 分析美国不同人口的ADHF住院趋势.
- 研究基于种族和性别的ADHF患病率,类型和结果的差异.
- 检查ADHF死亡率的时间变化,并确定影响生存的因素.
主要方法:
- 使用了来自社区动脉样硬化风险 (ARIC) 研究的数据,重点是2005年至2014年的心力衰竭住院情况 (年龄≥55岁).
- 使用国际疾病分类,第九次修订,临床修改代码进行初始识别,随后进行医生审查和算法验证.
- 分析了40173个验证的ADHF事件,按排射分数分层 (减少与保存 - HFpEF),种族和性别.
主要成果:
- 在黑人中,ADHF住院率最高,因性别和心力衰竭类型而有差异.
- 在过去十年中,患病率上升,主要是由于急性HFpEF,特别是在女性中.
- 虽然28天和1年死亡率始终很高 (约10%和30%),但黑人个体的生存率随着时间的推移有所改善,尤其是HFpEF的女性.
结论:
- 在研究的美国社区,ADHF住院,特别是HFpEF在2005-2014年间有所增加.
- 在所有人口和心力衰竭类型中,ADHF的一年生存率仍然是一个重大问题.
- 在黑人男性和女性中观察到1年死亡率的显著改善,这表明干预措施在这个群体中具有潜在的有效性.
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