了解心力衰竭的门诊患者的预后和死亡率估计
Thomas M Cascino1, Grace Herron1,2, Blair Richards3
1Division of Cardiovascular Medicine, University of Michigan, Ann Arbor.
JAMA network open
|March 3, 2026
概括
心力衰竭 (HF) 患者对自己的生存过于乐观,他们更有可能早死. 这凸显了在高级HF护理中需要客观风险评估的需要.
科学领域:
- 心脏病学 心脏病学
- 医学预测 医学预测
背景情况:
- 准确的预后理解对于高级心力衰竭 (HF) 患者的决策至关重要.
- 患者对生存率的高估可能会影响治疗选择和结果.
研究的目的:
- 确定与高频率患者生存率高估相关的患者特征.
- 为了确定生存率的高估是否与死亡率的增加有关.
主要方法:
- 使用REVIVAL研究数据进行的前性队列研究.
- 包括296名高风险的门诊患者,这些患者患有HF,射出分数减少.
- 使用回归模型分析估计指数 (EI) 和2年全因死亡率.
主要成果:
- 33.1%的患者对他们的预期寿命持不一致的乐观态度.
- 不一致的乐观情绪与近两倍增加的两年死亡风险有关 (AHR, 1.98).
- 即使考虑到心脏移植或VAD候选人,这种关联仍然存在.
结论:
- 关于预期寿命的不一致的乐观情绪在晚期HF患者中很常见.
- 这种乐观情绪独立地与死亡率的增加有关.
- 临床医生应该客观地评估HF风险,而不仅仅依赖患者自我报告的症状来做出先进治疗决策.
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