25年来心力衰竭的年龄特异性死亡率趋势:一项回顾性丹麦全国性队列研究
Caroline Hartwell Garred1, Morten Malmborg1, Mariam Elmegaard Malik1
1Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark.
The lancet. Healthy longevity
|May 5, 2024
概括
在所有年龄组中,心力衰竭患者的死亡率在25年内显著下降. 然而,在80岁及以上的人群中,这种减少不那么明显,这凸显了针对性策略的需要.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 老年病的医生 老年病的医生
背景情况:
- 心力衰竭 (HF) 护理的进步已经改善了试验的结果,但各年龄组的现实世界预期寿命趋势仍然不清楚.
- 调查不同HF患者群体的长期死亡趋势对于了解治疗影响至关重要.
研究的目的:
- 分析心力衰竭患者的25年死亡趋势,按年龄分层.
- 为了比较心力衰竭患者的死亡率变化与年龄和性别匹配的对照.
主要方法:
- 丹麦全国范围的登记处确定了194,997名新发性心力衰竭患者 (18-95岁).
- 卡普兰-梅尔估计和考克斯回归评估了5年全因死亡风险和绝对风险差异.
- 分析了五个日历时期 (1996-2020) 和三个年龄组 (<65,65-79,≥80岁) 的死亡率趋势.
主要成果:
- 心力衰竭患者的整体5年死亡率从66% (1996-2000) 降至43% (2016-20).
- 在所有年龄组中观察到显著的死亡率下降,年轻人群 (<65岁和65-79岁) 的绝对风险差异下降最大.
- 在80岁以上的患者中,死亡率的降低较少,绝对风险差异相对稳定.
结论:
- 25年来,心力衰竭患者的死亡率持续下降,使所有年龄组受益.
- 老年人 (≥80岁) 的死亡率改善程度较低,因此需要进一步研究有效的策略,以管理心力衰竭负担.
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