心脏衰竭成年人死亡的地方:来自CDC-WONDER数据库的见解
Farman Ali1, Shaaf Ahmad2, Aman Ullah3
1Department of Internal Medicine, Corewell Health Dearborn Hospital, Dearborn, MI (F. Ali, T.J.B.).
Circulation. Heart failure
|May 16, 2025
概括
1999年至2023年期间,心力衰竭 (HF) 患者在家中的死亡人数几乎翻了一番. 这项研究分析了HF死亡率的位置,揭示了生命终端护理环境中的显著转变和人口差异.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 老年学是指老年学的学科.
背景情况:
- 心力衰竭 (HF) 是导致死亡的首要原因和医疗保健支出的重要原因.
- 愈来愈多地强调将息治疗纳入HF管理中.
- 对HF患者终身护理地点的数据仍然有限.
研究的目的:
- 分析美国心力衰竭成年人死亡的位置和情况.
- 为了确定心力衰竭患者随着时间的推移而死亡的趋势.
- 检查与心力衰竭中死亡位置相关的人口因素.
主要方法:
- 对从1999年到2023年为20岁以上的个体的死亡率数据进行分析,其中HF是死亡原因.
- 死亡地点的分类:急诊室,宿舍/养老院,住院设施或家庭.
- 多项逻辑回归用于评估人口统计和死亡地点之间的关联.
主要成果:
- 心力衰竭死亡率下降到2010年,然后增加到2023年.
- 在家中死亡的比例几乎翻了一番,从1999年的18.41%增加到2023年的33.47%.
- 临终关怀/养老院死亡率在2017年达到峰值,到2023年下降;年轻人显示住院患者死亡率较高.
- 男人,白人和大都市地区的人更有可能在医疗机构死亡.
结论:
- 观察到心力衰竭患者生命终结地点的显著变化,家庭死亡人数显著增加.
- 最近临终关怀/养老院死亡人数的下降,需要进一步调查潜在的障碍.
- 社会人口统计学因素显著影响心力衰竭死亡地点的差异,需要进一步研究.
相关概念视频
01:22Heart Failure Drugs: Diuretics
298
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
298
01:22Heart Failure Drugs: β-Blockers
284
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
284
01:17Pathophysiology of Heart Failure
1.4K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.4K
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
331
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
331
01:26Heart Failure Drugs: Inotropic Agents
445
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
445
01:26Imbalances in Cardiac Output
1.2K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.2K