在心力衰竭住院患者中减肥的预后值
Takanori Nagahiro1, Masaaki Konishi1,2,3, Nobuyuki Kagiyama4,5,6
1Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura Kanazawa-ku, 236-0004 Yokohama, Japan.
概括
住院心力衰竭 (HF) 患者的显著体重减轻 (>12%) 预测了更高的死亡率,主要来自非心血管原因. 这一发现突显了体重减轻作为HF管理中的关键预后指标.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 内部医学 内部医学
背景情况:
- 体重减轻是慢性心力衰竭 (HF) 已知的预后不良因素.
- 住院HF患者体重减轻的预后价值,一个关键的诊断窗口,仍然不清楚.
- 这项研究探讨了因HF住院的老年患者减肥的预后意义.
研究的目的:
- 为了研究心力衰竭住院患者减肥的预后价值.
- 为了确定是否显著的入院前体重减轻与出院后的死亡率增加有关.
主要方法:
- 对前性多中心FRAGILE-HF研究的后期分析.
- 包括1332名住院的老年人 (≥65岁) 患有HF.
- 在入院前一年的自我报告体重与脱血后的体重进行比较,以评估体重减轻的百分比.
主要成果:
- 86.8%的患者体重减轻,中位数变化为-6.9%.
- 体重减轻>12% (最低四分位数) 与较高的全因死亡率 (P=0.024) 和非心血管死亡率 (P=0.028) 有关.
- 经过调整后,考克斯的比例危险模型证实>12%的体重减轻是高死亡率的预测因素 (aHR: 1.485,P=0.018).
结论:
- 住院前体重减轻 (>12%) 是因高血压而住院的老年患者死亡率增加的重要预测因素.
- 这种关联主要是由非心血管原因驱动的.
- 体重减轻的评估对于住院HF患者的风险分层至关重要.
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