心衰患者临床事件风险预测模型构建

Construction of risk prediction model for clinical events in patients with heart failure

研究调查了来自住院、门诊和养老院的136名心力衰竭患者的社会人口学因素、可改变风险因素、患者的健康状况和临床事件之间的关系。采用X^(2)检验、Mann-Whitney U检验等方法计算性别、年龄、患者健康状况等变量对出院患者1 a内死亡率和再入院率的影响。采用Cox风险模型对1 a内的全因死亡进行建模,使用Prentice-Williams-Peterson(PWP)模型对心衰患者再入院进行建模。心功能等级差、肥胖和体力活动较少是1 a随访期间临床事件的预测因子,心功能等级差是1 a内反复入院的预测因子。建议加强出院后的随访,增强心脏康复锻炼,配合护理人员的个性化教育来减少死亡和再入院的风险。

To examine the association of sociodemographic factors,modifiable risk factors,patient s well-being,and clinical events in patients with heart failure(HF).A convenience sample of 136 patients with HF from inpatient,outpatient,and long-term care settings was used.X^(2) test,Mann-Whitney U test,etc.,were used to calculate the influence of univariate such as gender,age,and patient s health status on the mortality and readmission rate of discharged patients within one year.The Cox proportional hazards regression model was used to model all-cause mortality within one year.The Prentice-Williams-Peterson(PWP)model was used to model hospital encounters.Poor functional class,obesity,and being less physically active were predictors of clinical events during the 1-year follow-up.Low levels of cardiac function were predictive of rehospitalization within one year among elderly HF patients,it is recommended to strengthen follow-up after discharge.Follow-up cardiac rehabilitation exercise after discharge combined with nurse practitioners personalized education is suggested to be used to slow HF progression and prevent rehospitalization.