状况和心力衰竭死亡之前的事件:一个现实世界的全国性研究
Deewa Zahir Anjum1, Caroline Hartwell Garred1, Nicholas Carlson2
1Department of Cardiology, Copenhagen University Hospital, Hellerup, Denmark.
European journal of heart failure
|March 2, 2025
概括
心力衰竭患者在死亡之前经常经历急性损伤 (AKI) 和末期病 (ESKD),特别是那些功能较低 (eGFR) 患者. 衰退在生命的最后几个月加速.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
背景情况:
- 慢性病 (CKD) 是心力衰竭 (HF) 患者常见的并发症.
- 慢性病显著影响HF预后和患者死亡率.
- 了解HF中功能下降对于患者护理至关重要.
研究的目的:
- 调查临近生命终点的HF患者的功能和不良事件之间的关系.
- 评估与基线功能相关的急性损伤 (AKI) 和末期病 (ESKD) 的发生率.
- 为了检查功能下降的轨迹在死亡前的最后一年.
主要方法:
- 分析了36435名已故高血压患者的注册数据 (2014-2021年).
- 根据死亡前一年估计的淋巴细胞过率 (eGFR) 分类的患者 (≥60,30-59,<30毫升/分钟/1.73米2).
- 在死亡前三个月评估脏不良事件 (AKI,ESKD) 和功能变化.
主要成果:
- 在HF患者中,17%的患者在死亡前一年的EGFR<30ml/min/1.73m2.
- 脏不良事件发生在13.1%的患者中,在较低的eGFR群体中发生率更高.
- 在最低的EGFR组 (<30毫升/分钟/1.73米2) 中,AKI发生率为21.9%,ESKD为35.5%.
- 在死亡前的最后三个月观察到显著的功能下降和替代疗法的需求增加.
结论:
- AKI和ESKD在生命最后一年的HF患者中很普遍.
- 较低的基线eGFR与不良事件的风险增加密切相关.
- 在HF患者死亡前的最后几个月里,功能下降加速.
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