第一次心力衰竭后的死亡率,结果,成本和药物的使用 住院治疗:进化 HF
Biykem Bozkurt1, Gianluigi Savarese2, Samuel Adamsson Eryd3
1Winters Center for Heart Failure, Cardiovascular Research Institute, Baylor College of Medicine, Houston, Texas, USA.
JACC. Heart failure
|June 24, 2023
概括
由于心力衰竭 (hHF) 的住院导致高的再住院率和成本. 准则导向医学疗法 (GDMT) 的使用仍然很低,这表明需要更早,更广泛地实施以改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 药物经济学 药物经济学
背景情况:
- 由于心力衰竭 (hHF) 住院后的结果,成本和治疗的当代数据有限.
- 了解出院后的发展轨迹对于改善患者护理和资源配置至关重要.
研究的目的:
- 描述再住院,医疗费用,死亡率,以及使用指南导向医疗疗 (GDMT) 后hHF.
- 确定重新住院和相关医疗保健支出的主要驱动因素.
主要方法:
- 进化HF是一个使用电子健康记录或索赔数据的跨国观察队列研究.
- 包括在日本,瑞典,英国和美国的2018年至2022年间首次hHF排放的成年人.
- 计算了死亡和再住院的1年事件率 (HF,CKD,MI,中风,PAD),并总结了医疗保健成本和GDMT使用情况.
主要成果:
- 在263,525名患者中,28%的患者在hHF后1年内死亡;重入院主要是由心力衰竭 (HF) 和慢性病 (CKD) 驱动的.
- 医疗费用主要与HF和CKD入院有关.
- 大多数GDMT的使用保持稳定,除了2020-2022年期间-葡萄糖共运输体-2抑制剂增加2至7倍之外.
结论:
- 高度的hHF后再住院率和相关成本仍然存在.
- 退院后GDMT使用的有限变化凸显了护理上的差距.
- 早期和更广泛地实施GDMT对于减轻风险和降低成本至关重要.
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