多中心心力衰竭队列患者住院时间影响因素分析

Analysis on influencing factors of length of hospital stay in a multicenteRheart failure cohort

目的分析多中心心力衰竭队列患者的住院资料,旨在探讨区域内影响住院时间的影响因素,为进一步的干预提供数据支持。方法将入选多中心、前瞻性心力衰竭队列的2794例患者,根据住院时间中位数分为长住院时间组(≥9 d)和短住院时间组(<9 d),比较两组患者一般资料的差异,将单因素分析存在统计学差异的因素纳入Logistic多因素回归分析,分析影响患者住院时间的因素。根据左室射血分数(LVEF)将患者分成射血分数保留的心力衰竭(HFpEF)组、射血分数轻度降低的心力衰竭(HFmrEF)组和射血分数降低的心力衰竭(HFrEF)组,分别进行多因素回归分析,探讨患者住院时间影响因素。结果Logistic多因素回归分析显示,LVEF、肺部感染、氨基末端脑钠肽前体(NT-proBNP)、血清钠、心脏再同步化治疗(CRT)或植入型心律转复除颤器(ICD)植入、β受体阻滞剂、醛固酮受体拮抗剂、正性肌力药物和血管扩张剂的使用均是影响HF患者住院的因素。CRT/ICD植入、正性肌力药物和血管扩张剂使用是HFpEF组、HFmrEF组和HFrEF组影响住院时间的共同因素。结论LVEF、肺部感染、NT-proBNP、血清钠、CRT或ICD植入、β受体阻滞剂、醛固酮受体拮抗剂、正性肌力药物和血管扩张剂使用是HF患者住院时间的影响因素。

Objective To analyze the length of hospital stay of patients with heart failure in a multicenteRcohort in ordeRto explore the influencing factors of length of stay and provide data support foRfurtheRintervention.Methods A total of 2794 patients enrolled in the multicenteRprospective heart failure cohort were divided into two groups:long hospital stay group(≥9 days)and short hospital stay group(<9 days).The general data of the two groups were compared,and the factors with statistical difference in univariate analysis were included in Logistic multifactoRregression analysis to explore the difference in length of hospital stay between the two groups.According to left ventriculaRejection fraction(LVEF),patients were divided into heart failure with preserved reduced ejection fraction(HFpEF)group,heart failure with mildly reduced ejection fraction(HFmrEF)group and heart failure with reduced ejection fraction(HFrEF)group,and Logistic multifactoRregression analysis was performed to find influencing factors.Results Logistic multifactoRregression analysis showed that LVEF,pneumonia,N-terminal pro-B-type natriuretic peptide(NT-proBNP),serum sodium,cardiac resynchronization therapy(CRT)oRimplantable cardioverteRdefibrillator(ICD)implantation,βblockers,aldosterone receptoRantagonists,positive inotropic drugs and vasodilators were all factors influencing the hospitalization of HF patients.In the HFpEF,HFmrEF,and HFrEF groups,CRT/ICD implantation,positive inotonic drugs,and vasodilatoRuse were suggested to be common factors affecting length of hospital stay in all three groups.Conclusion LVEF,pneumonia,NT-proBNP,serum sodium,CRT oRICD implantation,βblockers,aldosterone receptoRantagonists,positive inotropic drugs and vasodilators are the influencing factors of hospitalization time in HF patients.