多种疾病共存是心力衰竭住院患者在院病死率的独立预测因子

Coexistence of Multiple Disease is an Independent Predictor of In-hospitalized Mortality Patients with Congestive Heart Failure

目的本项研究主要是调查充血性心力衰竭(congestive heart failure,CHF)住院患者多种疾病共存分布特点,及对CHF患者30天在院病死率的影响。方法 6949名CHF住院患者(男性4344例,女性2605例)按照共存疾病数目分成5组,采用COX比例风险模型比较各组间的共存疾病特点及30天在院病死率。结果 CHF住院患者的主要病因是冠心病(45%)、瓣膜性心脏病(27.5%)和肺心病(9.6%)。年轻人以单病因为主(18～39岁,P<0.001),老年人以多种疾病共存为主(≥80岁,P<0.001)。最常见的单病因是瓣膜性心脏病,最常见的多病因是冠心病伴发高血压、糖尿病。COX风险回归模型显示CHF住院患者的在院病死率随疾病数目的增加而增加(P<0.001)。结论多种疾病共存是预测CHF住院患者在院30天病死率的独立危险因素。

Objective To investigate the major causes,comorbidities and 30-day mortality of congestive heart failure（CHF） in hospitalized patients.Methods All 6949 patients（4344 males,2605 females） of CHF were identified and divided into five groups according to the number of comorbidities.Cox proportional hazards regression was used to examine the association between the number of comorbidities and in-hospital mortality in patients with CHF.Results The major causes of hospitalized patients with CHF were coronary artery disease（45.0%）,vavular heart disease（27.5%） and cor Pulmonale（9.6%）.A single comorbidity was predominant in younger patients（18-39 years,P0.001）,while multiple comorbidities were predominant in the elderly（≥80 years,P0.001）.The most common single etiology was valvular heart disease,and the most common triple etiology was hypertension and diabetes mellitus complicated by coronary artery disease.Cox regression analysis showed a higher hospital mortality rate associated with an increased number of comorbidities（P0.001）.Conclusion This study demonstrates the coexistence of multiple diseases is an independent predictor of the 30-day mortality of hospitalized patients with CHF.