心房颤动伴慢性心力衰竭患者多次住院相关危险因素分析

Analysis of Risk Factors Associated with Multiple Hospitalizations in Patients with Atrial Fibrillation with Chronic Heart Failure

目的 探讨心房颤动伴慢性心力衰竭患者一年内多次住院的相关危险因素。方法 纳入2017年9月—2021年12月在贵州医科大学附属乌当医院心血管内科住院的心房颤动伴慢性心力衰竭患者533例作为研究对象。按年最大住院次数≥2次的心房颤动伴慢性心力衰竭患者定义为多次住院组,<2次的心房颤动伴慢性心力衰竭患者定义为非多次住院组,其中多次住院组患者220例,非多次住院组313例。应用二元Logsitic回归模型分析心房颤动伴慢性心力衰竭患者发生多次住院的影响因素。结果 两组患者中多次住院组年龄更大、女性、缺血性卒中/暂性脑缺血发作(TIA)、冠心病、持续性心房颤动例数更多,差异有统计学意义(P<0.05)。二元Logsitic多因素回归显示年龄(OR=1.040、95%CI 1.021~1.058,P<0.001)、女性(OR=2.475、95%CI1.693~3.619,P<0.001)、冠心病(OR=1.602、95%CI 1.030~2.493,P=0.037)、持续性心房颤动(OR=1.605、95%CI1.112~2.317,P=0.012)、缺血性卒中/TIA(OR=1.579、95%CI 1.003~2.488,P=0.049)是导致心房颤动伴慢性心力衰竭患者多次住院的独立危险因素。结论 心房颤动伴慢性心力衰竭患者年龄、女性、冠心病、持续性心房颤动、缺血性卒中/TIA是患者多次住院的危险因素。

Objective To investigate the risk factors associated with multiple hospitalizations within one year in patients with atrial fibrillation with chronic heart failure.Methods Five hundred and thirty-three patients with atrial fibrillation with heart failure admitted to the Department of Cardiovascular Medicine of Wudang Hospital Affiliated to Guizhou Medical University from September 2017 to December 2021 were enrolled as the research object.Patients with atrial fibrillation with heart failure defined as multiple hospitalization group according to the maximum number of hospitalizations≥2 times per year,and patients with atrial fibrillation with heart failure<2 times per year defined as non-multiple hospitalization group,of which two hundred and twenty patients were in the multiple hospitalization group and three hundred and thirteen patients were in the non-multiple hospitalization group.A binary Logsitic regression model was applied to analyze the factors influencing the occurrence of multiple hospitalizations in patients with atrial fibrillation with heart failure.Results Among the two groups,the patients in the multiple hospitalization group were older,and the number of women,ischemic stroke/transient ischemic attack(TIA),coronary heart disease,and persistent atrial fibrillation were more,the difference was statistically significant(P<0.05).Binary Logsitic multivariate regression showed:age(OR=1.040,95%CI 1.021-1.058,P<0.001),female(OR=2.475,95%CI 1.693-3.619,P<0.001),coronary heart disease(OR=1.602,95%CI 1.030-2.493,P=0.037),persistent AF(OR=1.605,95%CI 1.112-2.317,P=0.012),ischemic stroke/TIA(OR=1.579,95%CI 1.003-2.488,P=0.049)was an independent risk factor for multiple hospitalizations in patients with atrial fibrillation with heart failure.Conclusion Age,female,coronary artery disease,persistent atrial fibrillation,and ischemic stroke/TIA are risk factors for multiple hospitalizations in patients with atrial fibrillation with heart failure.