在心力衰竭住院后,医疗保险受益人中的脏结果
John W Ostrominski1, Stephen J Greene2,3, Ravi B Patel4
1Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
JAMA cardiology
|May 29, 2024
概括
6%的患有心力衰竭的老年人在住院一年内得到透析. 下功能 (eGFR) 显著增加了这种风险,突出显示了HF管理中需要综合护的需要.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
背景情况:
- 心力衰竭 (HF) 管理越来越多地包括脏健康.
- 然而,当代高频人口中的结局需要进一步研究.
研究的目的:
- 调查医疗保险受益人心力衰竭后住院治疗的透析和急性损伤 (AKI) 的发生率.
- 分析排泄估计的膜过率 (eGFR) 和随后的结局之间的关联.
主要方法:
- 对85298名65岁以上的成年人进行了回顾性队列研究,他们因HF住院治疗 (2014-2018).
- 医疗保险索赔数据被用于追踪退院后长达一年的结果.
- 考克斯的比例危险回归模型被用来评估放电eGFR与结果之间的关系.
主要成果:
- 在一年内,6%的患者开始透析,7%的患者进展到透析或末期脏疾病,7%的患者因AKI重新入院.
- 较低的EGFR排泄与透析,脏疾病和AKI风险增加密切相关.
- 例如,eGFR<30mL/min/1.73m2对应于与eGFR≥60.6相比,透析再入院的风险增加了28倍.
结论:
- 患有HF的老年人面临脏并发症的重大风险,显著的百分比需要住院后进行透析.
- 这些发现强调了对医疗保健策略的急需,这些策略优先考虑心力衰竭患者的脏健康.
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