摘要
目的 分析老年心房颤动(简称房颤)住院患者的入院躯体功能状态对出院后短期内的跌倒、非计划性再入院和死亡的预测作用,以期改善患者的预后状态。方法 采用前瞻性观察性队列研究设计,通过便利抽样法选取2018年9月至2019年2月于北京医院心内科住院的老年房颤患者为研究对象。使用简易躯体能力评估(Short Physical Performance Battery,SPPB)调查其入院时的躯体功能状态,并对入组后6个月内的预后(跌倒、非计划性再入院和死亡)情况进行随访。采用Kaplan-Meier生存分析法绘制患者预后的生存曲线,并采用Cox风险比例回归模型探究躯体功能状态对预后的影响。结果 本研究最终纳入153例老年房颤住院患者,36.6%(56例)在6个月内出现跌倒、非计划性再入院或死亡,66.0%(101例)有躯体功能障碍。Kaplan-Meier生存分析显示躯体功能障碍的患者终点事件发生时间更早(χ2=3.926,P=0.048);Cox回归显示SPPB总分是终点事件的独立危险因素(HR=0.916,95%CI:0.849~0.988,P=0.023)。另外,饮酒、合并心肌梗死或肾功能不全也可独立增加不良预后的风险(P<0.05)。结论 老年房颤住院患者入院时的躯体功能状态可以独立预测出院后6个月内的跌倒、非计划性再入院和死亡的发生风险,相关工作人员可通过及时、准确评估SPPB以减少患者不良预后的发生。
Objective In order to improve the prognosis of patients,we aimed to analyze the prediction of physical function on fall,unplanned readmission and mortality in elderly patients with atrial fibrillation.Methods A prospective observational cohort study design was used,and elderly patients with atrial fibrillation admitted to the Department of Cardiology of Beijing Hospital from September 2018 to February 2019 were selected as subjects by convenience sampling method.Physical function at admission was investigated using Short Physical Performance Battery(SPPB),and outcomes(fall,unplanned readmission,and mortality)were followed up within 6 months.Kaplan-Meier survival analysis method was used to draw the survival curve of patients'prognosis,and Cox proportional regression model was used to explore the influence of physical function on prognosis.Results A total of 153 elderly patients with atrial fibrillation were enrolled in this study.36.6%(56)appeared fall,unplanned readmission or mortality within 6 months,and 66.0%(101)among which appeared physical dysfunction.Kaplan-Meier survival analysis showed that endpoint events occurred earlier in patients with physical dysfunction(χ2=3.926,P=0.048).Cox regression showed that total SPPB score was an independent risk factor for endpoint events(HR=0.916,95%CI:0.849-0.988,P=0.023).In addition,regular alcohol consumption combined with myocardial infarction or renal insufficiency independently increased the risk of poor prognosis(P<0.05).Conclusions The physical function status of elderly patients with atrial fibrillation at admission can independently predict the risk of fall,unplanned readmission and mortality within 6 months after discharge,and relevant staff can reduce the occurrence of poor prognosis by timely and accurate assessment of SPPB.
作者
崔玲玲
王华
王颖
林鹏
严蕊
Cui Lingling;Wang Hua;Wang Ying;Lin Peng;Yan Rui(Department of Cardiology,Beijing Hospital,National Centre of Gerontology,Geriatric Research Institute,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中国医学前沿杂志(电子版)》
CSCD
2023年第7期41-47,共7页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
北京市科技重大专项(D181100000218003)。
关键词
预后
躯体功能
老年
心房颤动
住院
Prognosis
Physical Performance
Aged
Atrial Fibrillation
Hospitalization