Work status before admission relates to prognosis in older patients with heart failure partly through social frailty
Work status before admission relates to prognosis in older patients with heart failure partly through social frailty
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入院前的工作状态与老年心力衰竭患者的预后相关，部分原因是社交脆弱
DOI：
10.1016/j.jjcc.2021.10.029
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发表时间：
2022
影响因子：
2.5
通讯作者：
et al.
中科院分区：
文献类型：
--
作者：
Yamashita Masashi;Kamiya Kentaro;Hamazaki Nobuaki;et al.
背景没有报告明确研究被定义为某种类型的社会参与或角色的工作与通过预防虚弱而对心力衰竭(HF)患者预后的保护作用之间的关系。因此，作为一项多中心前瞻性研究(脆性心力衰竭研究)的第二次分析，本研究探讨了入院前通过工作的社会参与是否与65岁≥心力衰竭患者未来的不良事件有关，以及每个脆弱领域是否在工作和预后之间起中介作用。我们评估了脆弱的生理、认知和社会领域，并进行了因果中介分析，以检验入院前工作状态与1年合并事件(心力衰竭相关再住院和全因死亡)之间的中介关系。结果受试者的中位年龄为81岁，其中56.9%(758/1,332)为男性。在脆弱的三个领域中，入院前的工作仅在调整混杂因素后降低了社会脆弱(优势比：0.505，95%可信区间：0.364-0.701)。入院前有工作的患者预后较好(危险比：0.720，95%可信区间：0.523-0.989)。仅社会脆弱性在工作状态与合并事件之间起部分中介作用(p<；0.05)。结论入院前的工作状态与1年合并事件有关，部分是通过社会脆弱。
BackgroundNo reports explicitly examined the relationship between work defined as a certain type of social participation or role and the protective effect on the prognosis of patients with heart failure (HF) by preventing frailty. Therefore, this study examined whether social participation through work before admission relates to future adverse events in HF patients aged ≥65 years, and whether each frailty domain mediates the association between work and prognosis as a second analysis of a multi-centered prospective study (FRAGILE-HF study).MethodsWe retrospectively reviewed 1,332 older patients with HF whose work status before admission to the hospital were investigated. We assessed the physical, cognitive, and social domains of frailty and performed causal mediation analysis to examine the mediating relationship of each frail domain between work status before admission and 1-year combined events (HF-related readmission and all-cause death).ResultsThe subjects’ median age was 81 years, and 56.9% (758/1,332) were male. Among the three domains of frailty, work before admission reduced only social frailty after adjusting for confounding factors (odds ratio: 0.505, 95% confidence interval: 0.364-0.701). Patients with work before admission had a significantly better prognosis (hazard ratio: 0.720, 95% confidence interval: 0.523-0.989). Only social frailty partly mediated the relationship between work status and combined events (p<0.05).ConclusionsWork status before admission is associated with 1-year combined events, in part through social frailty.