患有血液性恶性瘤的患者急性心力衰竭:全国性的分析2016-2021年
Barath Prashanth Sivasubramanian1, Diviya Bharathi Ravikumar2, Siva Naga S Yarrarapu3
1Department of Internal Medicine, Northeast Georgia Medical Center, Gainesville, GA, USA.
SAGE open medicine
|October 24, 2025
概括
在癌症患者中,急性心力衰竭令人惊地降低了住院死亡风险. 然而,严重的败血症和器官功能障碍仍然是这种脆弱的血液恶性瘤群体中不良结果的关键预测因素.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 急性心力衰竭 (AHF) 影响大约9%的血液恶性瘤 (HM) 患者.
- 了解AHF对HM患者住院死亡率的影响对于改善护理至关重要.
- 在这个人群中确定死亡率预测因素可以指导临床管理.
研究的目的:
- 评估AHF对HM患者住院死亡率的影响.
- 确定在经历AHF的HM患者中死亡率的独立预测因素.
主要方法:
- 利用国家住院样本 (NIS) 数据库从2016年到2021年.
- 包括HM和住院死亡率的成年患者 (≥18岁),特别确定那些患有AHF的患者.
- 采用单变量和多变量回归分析来评估死亡风险 (p ≤0.05).
主要成果:
- 单变量分析显示AHF队列中的死亡率较高 (8.08%与4.52%,p < 0.001).
- 多变量分析显示,在调整后,AHF与较低的住院死亡风险相关 (OR 0.87,95% CI 0.84-0.9,p < 0.001).
- 在AHF队列中的关键死亡预测因素包括年龄>60,干细胞移植,严重败血症,心律失常,传染性内心炎,出血,急性呼吸衰竭,肝功能障碍,代谢性脑病变和侵入性通风 (所有p <0.01).
- 亚组分析表明,针对特定的HM类型 (AML,CML,CLL,MM) 的AHF死亡率更高.
结论:
- 在HM患者中,AHF与严重的败血症,器官功能障碍或机械通风伴随时的不良结果有关.
- 建议密切监测和多学科方法,以优化AHF患者在HM的护理.
- 需要进一步研究在HM患者中控制心脏毒性.
关键词:
在AML,AML就是AML.在 BCR/ABL 中,在 CLL CLL 中.在CML中,CML是CML.心脏衰竭是因为心脏衰竭.这种白血病是白血病.死亡率 死亡率多发性骨髓瘤是多发性骨髓瘤的一种.这是一种血症.更多相关视频
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