通过查尔森并发症指数 (Charlson Comorbidity Index) 来研究心房的多发症与临床影响
Moonki Jung1, Pil-Sung Yang2, Daehoon Kim1
1Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
International journal of cardiology
|November 24, 2023
概括
在心房患者中,高并发症负担增加了抗血小板使用,但降低了抗凝剂处方. 这种多病症显著增加了死亡,中风,出血和心力衰竭住院的风险.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 预测心房 (AF) 患者多种并发症的预后是复杂的.
- 查尔森并发症指数 (CCI) 是评估多病症的一个工具.
- 了解AF中高CCI的临床影响对于患者管理至关重要.
研究的目的:
- 评估高查尔森并发症指数 (CCI) 与新发性心房 (AF) 患者的临床结果之间的关联.
- 评估多病症对AF患者抗血栓治疗策略的影响.
- 根据CCI和AF状态来确定不良事件的风险分层.
主要方法:
- 分析了451,368名来自韩国国家医疗保险服务-健康查队列的参与者 (2002-2013).
- 分类为新发性AF和非AF组,高CCI定义为≥4.4.
- 在9年内对抗血栓治疗和结果 (全因死亡,中风,严重出血,心力衰竭住院治疗) 的评估.
主要成果:
- 在AF组中,高CCI (≥4) 的患者显示抗血小板使用增加 (aOR1.05) 和抗凝剂处方减少 (OR0.97).
- 副作用发生率逐渐增加:低CCI没有AF<高CCI没有AF<低CCI与AF<高CCI与AF.
- 与没有AF的低CCI相比,高CCI与AF的高CCI显著增加了所有原因死亡 (aHR 2.52),中风 (aHR 1.43),严重出血 (aHR 1.14) 和HF住院 (aHR 4.75) 的风险.
结论:
- 高CCI是AF患者抗血栓药物处方模式变化的预测指标.
- 心房动,特别是在高并发症的情况下,大大增加了心血管和死亡不良结果的风险.
- 使用CCI和AF状态进行风险分层对于优化多病患者的护理至关重要.
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