心力衰竭患者出院后1年内预后状况及影响因素分析

Prognosis Status With its Influencing Factors in Heart Failure Patients During 1 Year of Discharged Period

目的 :分析心力衰竭患者出院后1年内预后状况并探索其影响生存的因素。方法:采用问卷及电话调查的方法,收集心力衰竭患者入院前、住院期间及出院后的再住院或死亡等相关资料;采用Cox回归方法探讨心力衰竭再住院或死亡的影响因素。结果:共随访258例心力衰竭患者,平均随访约7个月。258例心力衰竭患者出院后1、3、6和12个月的因心力衰竭再住院率分别为1.9%、10.1%、14.3%、17.4%;因心力衰竭死亡率分别为2.3%、6.6%、8.9%、11.6%;因心力衰竭的联合再住院或死亡率分别为4.3%、16.7%、23.3%、29.1%;Kaplan-Meier生存曲线表明,因心力衰竭的累积再住院或死亡率分别为4.3%、16.7%、23.5%、34.3%。Cox生存分析表明,性别、手术治疗状况、血钠水平、血红蛋白浓度和NTpro-BNP水平是影响心力衰竭1年内再住院或死亡的因素。结论:心力衰竭患者1年内的累积再住院或死亡率为34.3%。性别、手术治疗状况、血钠浓度、血红蛋白浓度和NTpro-BNP水平仍是影响心力衰竭患者1年内生存的主要因素。

Objective： To analyze the prognosis status with its influencing factors in heart failure （HF） patients during 1 year of discharged period. Methods ： There were 258 patients with the mean followed-up time of 7 months, the questionnaire survey and telephone visit were performed to collect their clinical information, and Cox regression analysis was applied to explore the related factors for their re-hospitalization or mortality during that period of time. Results： The re-hospitalization rate in 258 patients caused by CH at 1, 3, 6 and 12 months after discharge were 1.9%, 10.1%, 14.3% and 17.4% respectively; the mortality were 2.3%, 6.6%, 8.9% and 11.6% respectively; the combination of re- hospitalization or mortality were 4.3%, 16.7%, 23.3% and 29.1% respectively. Kaplan-Meier survival curve presented that the accumulative re-hospitalization or mortality caused by CH were 4.3%, 16.7%, 23.5% and 34.3% respectively. Cox regression study showed that gender, the condition of surgery and the levels of blood sodium, hemoglobin and NT-proBNP were the influencing factors for 1 year re-hospitalization or mortality in CH patients. Conclusion： The 1 year accumulative re-hospitalization and/or mortality in CH patients were 34.3%. Gender, the condition of surgery and the levels of blood sodium, hemoglobin and NT-proBNP were the main influencing factors for CH patient＇s survival within 1 year.