慢性心力衰竭并房颤患者出院1年全因死亡因素预测

Predictors of 1-year All-cause Death in Patients with Chronic Heart Failure and Atrial Fibrillation

目的:探讨老年慢性心力衰竭合并房颤患者出院后随访1年全因死亡的因素预测。方法:选择2019年1月-2020年3月在石河子大学医学院第一附属医院住院治疗的老年慢性心力衰竭合并房颤患者233例,收集一般资料,对患者随访1年,记录有无全因死亡事件;把发生终点事件与未发生终点事件患者的一般资料进行对比,筛选单因素分析有统计学意义的变量进行多因素Logistic回归分析。结果:未发生终点事件与发生终点事件患者的资料进行对比发现:两组间性别、年龄、服药总数、总胆固醇、甘油三酯、低密度脂蛋白、白细胞计数、血小板计数、血红蛋白差异无统计学意义(P>0.05);共病总数、Barthel指数评分、心功能分级、血肌酐、白蛋白、D二聚体、LVEF值、病程差异有统计学意义(P<0.05);筛选单因素分析有统计学意义的变量进行多因素Logistic回归分析表明,老年慢性心力衰竭合并房颤患者出院1年全因死亡与Barthel指数评分、NYHA心功能分级、慢性心力衰竭病程密切相关(P<0.05)。结论:慢性心力衰竭病程长、NYHA分级高是老年慢性心力衰竭合并房颤患者出院1年全因死亡的独立危险因素,而Barthel指数评分高是老年慢性心力衰竭合并房颤患者出院1年全因死亡的保护因素。

Objective:To investigate the risk factors of one-year all-cause death in elderly patients with chronic heart failure and atrial fibrillation.Methods:A total of 233 elderly patients with chronic heart failure and atrial fibrillation who were hospitalized in the First Affiliated Hospital of Shihezi University from January 2019 to March 2020 were selected.The general data were collected.The patients were followed up for 1 year to record whether there were all-cause deaths.The general data of patients with and without endpoint events were compared,and the variables with statistical significance in univariate analysis were selected for multivariate logistic regression analysis.Results:There was no significant difference in gender,age,total dosage total cholesterol,triglyceride,low density lipoprotein,white blood cell count,platelet count and hemoglobin between the two groups(P>0.05).The total number of comorbidities,Barthel index score,cardiac function grade,serum creatinine,albumin,D-dimer,the course of chronic heart failure and LVEF were significantly different(P<0.05).Multivariate logistic regression analysis showed that Barthel index score,NYHA cardiac function classification and the course of chronic heart failure were closely related to all-cause death in elderly patients with chronic heart failure complicated with atrial fibrillation in one year after discharge(P<0.05).Conclusion:Long course of chronic heart failure and high NYHA grade are independent risk factors for all-cause death in elderly patients with chronic heart failure complicated with atrial fibrillation,while high Barthel index score is a protective factor for all-cause death in elderly patients with chronic heart failure complicated with atrial fibrillation.