eGFR斜率作为心力衰竭患者死亡率的预测指标
Sofie Verstreken1, Monika Beles1, Clara L Oeste2
1Cardiovascular Center, OLV Hospital, Aalst, Belgium.
ESC heart failure
|November 27, 2024
概括
慢性病 (CKD) 在心力衰竭 (HF) 患者中很常见,并预测死亡率. 估计的淋巴细胞过率 (eGFR) 降低和当前水平可以评估HF患者的死亡风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 临床流行病学临床流行病学
背景情况:
- 心力衰竭 (HF) 与功能受损有关,导致不良结果.
- 在HF患者中,估计的淋巴细胞过率 (eGFR) 轨迹的预后价值尚不清楚.
研究的目的:
- 分析eGFR轨迹对现实世界HF人口死亡率的影响.
- 调查慢性病患者慢性病 (CKD) 的患病率和预后意义.
主要方法:
- 从1986年HF患者的电子健康记录 (EHR) 的回顾性分析.
- 使用线性混合效应模型进行CKD评估和eGFR轨迹分析,用于数据提取的自然语言处理.
- 考克斯比例危险模型和联合建模以评估与基线变量和eGFR趋势相关的死亡风险.
主要成果:
- 58%的HF患者患有CKD; 39%患有心力衰竭与保存的喷射分数 (HFpEF).
- 慢性病患者的死亡率较高 (几乎翻了一番),基线特征较差.
- 每10mL/min/1.73m2 eGFR下降与死亡风险增加1.22倍相关;每10mL/min/1.73m2下降1年,死亡风险增加1.97倍.
结论:
- 慢性病在HF患者中普遍存在,是死亡率的独立预测因素.
- 当前的eGFR水平和过去一年的eGFR斜率都能帮助评估HF患者的个体死亡风险.
- 这些发现支持将eGFR轨迹监测纳入常规HF临床随访.
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