临床结果,医疗保健资源的利用和费用由功能在心力衰竭患者的临床结果,医疗保健资源利用和费用
Martín Romo1, Claudia Yuste2, Jorge Vélez3
1Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain.
Revista espanola de cardiologia (English ed.)
|September 21, 2025
概括
患有心力衰竭 (HF) 和恶化功能的患者面临更高的死亡率,更多的住院治疗和增加的成本. 早期干预对于管理这些复杂的病例和减少医疗保健负担至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 卫生经济学 卫生经济学
背景情况:
- 心力衰竭 (HF) 经常被慢性病 (CKD) 复杂化.
- 功能障碍显著影响HF预后和医疗保健资源利用.
- 在HF患者中量化CKD严重程度的影响对于临床管理至关重要.
研究的目的:
- 评估不同程度的功能障碍对HF患者临床结果的影响.
- 评估CKD严重程度对医疗保健资源利用和HF患者成本的影响.
- 为了比较不同类别的估计膜过率 (eGFR) 的结果,包括透析.
主要方法:
- 对3274名成年HF患者进行了回顾性队列研究.
- 基于EGFR水平 (≥60,30-59,15-29,<15毫升/分钟/1.73米2) 的一年临床结果,资源使用和成本的分析.
- 使用COHERENT模型进行医疗保健资源利用和成本评估.
主要成果:
- 较低的eGFR与增加的一年死亡率,再住院和急诊室访问相关.
- 患有eGFR<15mL/min/1.73m2的患者的再入院率最高 (50.8%).
- 随着eGFR的下降,患者的中位成本大幅上升,从3960欧元增加到9590欧元,主要是由于住院费用.
结论:
- 在HF患者中,逐渐严重的功能障碍与更糟糕的临床结果有关.
- 增加的医疗资源利用率和更高的医疗费用与HF中CKD恶化有关.
- 制定策略以改善严重CKD的HF患者的治疗结果和降低成本是非常必要的.
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