最近心力衰竭和伴随抑郁症的趋势,一项回顾性研究
Ovie Okorare1, Daniel Ubokudum2, Unwam Jumbo2
1Department of Internal Medicine, Vassar Brothers Medical Center, Nuvance Health, Poughkeepsie, NY.
Current problems in cardiology
|October 6, 2023
概括
患有抑郁症的心力衰竭患者住院的病例从2016年至2020年增加. 虽然住院死亡率有所不同,但相关的住院事件,如中风和呼吸衰竭显著增加.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 抑郁症与心力衰竭患者的结果更差有关,包括更高的再入院,功能减弱和死亡率.
- 了解心力衰竭患者患有抑郁症的趋势对于改善护理和预后至关重要.
研究的目的:
- 分析最近住院和住院死亡率的趋势 美国心力衰竭患者与同时出现的抑郁症.
- 为了确定五年期间相关的医院内事件和成本的变化.
主要方法:
- 从2016年到2020年全国住院患者样本 (NIS) 的数据使用.
- 包括心力衰竭和抑郁症诊断的成年患者 (≥18岁).
- 分析了住院死亡率,住院事件 (中风,心律失常,呼吸衰竭),住院时间和使用国际疾病分类第十版代码的成本.
主要成果:
- 患有抑郁症的心力衰竭患者的住院总数每年从126,317人增加到147,798人.
- 平均住院费用大幅上升 (34,954美元至44,151美元),而住院时间的中位数保持稳定 (4-5天).
- 住院事件的发生率,包括中风,心律失常和呼吸衰竭,显著增加 (P < 0.0001).
结论:
- 患有抑郁症的心力衰竭患者住院的病例正在上升,伴随着成本上升.
- 尽管总体死亡率趋势稳定,但临界住院事件的发生率显著增加,突出显示并发症负担越来越大.
相关概念视频
01:30Heart Failure IV: Classification and Diagnostic Evaluation
19
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
19
01:26Heart Failure III: Clinical Manifestations
22
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
22
01:29Heart Failure II: Pathophysiology
14
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
14
01:27Heart Failure I: Introduction
14
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
14
01:30Heart Failure V: Medical Management
10
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
10
01:30Heart Failure VII: Nursing Interventions
86
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
86