患有心力衰竭的老年患者的住院相关残疾和1年死亡风险
Michitaka Kato1, Koji Sakurada2, Masakazu Saitoh3
1Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan; Committee of the J-Proof HF Registry, Japanese Society of Cardiovascular Physical Therapy, Tokyo, Japan.
Journal of the American Medical Directors Association
|March 18, 2025
概括
住院相关残疾 (HAD) 在老年心力衰竭患者中显著增加死亡风险. 在住院期间预防ADL下降对于更好的长期结果至关重要.
科学领域:
- 老年学是一门学科.
- 心脏病学 心脏病学
- 康复医学 康复医学 康复医学
背景情况:
- 住院相关残疾 (HAD) 影响老年人,定义为日常生活基本活动 (ADLs) 的丧失.
- 患有心力衰竭 (HF) 的老年患者在住院期间特别容易受到功能衰退的影响.
- 在独立的ADL患者中,HAD的预后意义仍然未得到充分研究.
研究的目的:
- 调查HAD是否是HF老年患者的显著预后风险因素.
- 确定HAD与退院1年后死亡率和再住院之间的关联.
- 分析轻度与严重HAD对死亡风险的影响.
主要方法:
- 日本的一项前性,全国性的多中心注册表研究.
- 包括6519名老年患者 (≥65岁) 患有HF,独立于入院前的ADL.
- HAD定义为在出院时巴特尔指数 (BI) 降低≥5点;结果:1年全因死亡率,HF死亡率,再住院.
主要成果:
- 一年死亡率:12%,所有原因,5%与HF相关;再住院:41%.
- HAD显著增加了一年全因死亡率 (aHR,1.749).
- 严重的HAD比轻度的HAD带来更高的死亡风险;HAD预测HF死亡率,但没有重新住院.
结论:
- 在以前在ADL中独立的老年HF患者中,HAD是1年死亡率的重要风险因素.
- 在住院期间预防ADL下降对于改善这一群体的预后至关重要.
- 缓解ADL损伤可以降低出院后死亡风险.
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