老年慢性心力衰竭加重患者多次住院的危险因素

Risk Factors for Multiple Hospitalizations of Elderly Patients with Chronic Heart Failure Worsens

目的探讨老年慢性心力衰竭加重患者多次住院的危险因素。方法回顾性分析2019年1月至2020年12月于泌阳县人民医院因慢性心力衰竭加重住院治疗并缓解出院的老年患者,收集患者的临床特征、治疗情况及连续12个月的随访情况,观察终点为年最大住院次数。依据年最大住院次数将研究对象分为多次住院组(年最大住院次数≥2次)及非多次住院组(年最大住院次数<2次)。对比两组患者的一般资料,采用多因素logistic回归对老年慢性心力衰竭加重患者多次住院的危险因素进行分析。结果共纳入361例患者,多次住院组82例(22.7%),非多次住院组279例(77.3%)。两组在性别、合并症等方面差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,心脏瓣膜病(OR=1.992,95%CI 1.319~2.289,P=0.002)、心房颤动(OR=3.780,95%CI 1.790~4.675,P=0.038)、肾功能不全(OR=2.938,95%CI 1.233~6.312,P=0.004)、陈旧性心肌梗死(OR=1.765,95%CI 1.376~2.932,P=0.026)是老年慢性心力衰竭加重患者多次住院的独立危险因素,女性(OR=0.706,95%CI 0.687~0.986,P<0.001)是老年慢性心力衰竭加重患者多次住院的保护性因素。结论心脏瓣膜病、心房颤动、肾功能不全、陈旧性心肌梗死与老年慢性心力衰竭加重患者多次住院风险增加相关,女性是多次住院风险的保护性因素。

Objective To explore the risk factors of multiple hospitalization in elderly patients with chronic heart failure worsens.Methods From January 2019 to December 2020,elderly patients who were hospitalized for exacerbation of chronic heart failure worsens and discharged with remission in Biyang County People’s Hospital were consecutively included.The clinical features,treatment and follow-up for 12 months were collected.The end point of observation was the maximum number of hospitalizations per year.According to the annual maximum number of hospitalization,the study subjects were divided into multiple hospitalization group(annual maximum number of hospitalization≥2 times)and non-multiple hospitalization group(annual maximum number of hospitalization<2 times).The normal characteristics were compared and multivariate logistic regression was used to analyze the risk factors of multiple hospitalization in elderly patients with chronic heart failure.Results A total of 361 patients were included,82(22.7%)patients were included in multiple hospitalizations group,279(77.3%)patients were included in non-multiple hospitalizations group.There were statistically significant differences between the two groups in age and complications(P<0.05).Multivariable logistic regression analysis showed valvular heart disease(OR=1.992,95%CI 1.319-2.289,P=0.002),atrial fibrillation(OR=3.780,95%CI 1.790-4.675,P=0.038),renal insufficiency(OR=2.938,95%CI 1.233-6.312,P=0.004),and prior myocardial infarction(OR=1.765,95%CI 1.376-2.932,P=0.026)were independent risk factors for multiple hospitalizations,while female(OR=0.706,95%CI 0.687-0.986,P<0.001)was the protective factor for multiple hospitalizations.Conclusion Valvular heart disease,atrial fibrillation,renal insufficiency,and prior myocardial infarction are related to an increased risk of multiple hospitalizations among elderly chronic heart failure worsens patients,while female is a protective factor for the risk of multiple hospitalizations.