Impact of congestive heart failure, chronic kidney disease, and anemia on survival in the medicare population
Impact of congestive heart failure, chronic kidney disease, and anemia on survival in the medicare population
复制标题
DOI：
10.1016/j.cardfail.2004.03.003
复制
发表时间：
2004-12-01
影响因子：
6
通讯作者：
Collins, AJ
中科院分区：
文献类型：
--
作者：
Herzog, CA;Muster, HA;Collins, AJ
背景：充血性心力衰竭（CHF）是老年人常见的临床问题，但很少有研究集中在这一人群。此外，慢性肾脏疾病（CKD）和贫血在老年患者CHF的死亡率的信息是lacking.Methods和结果：一个队列的1,136,201例患者在5%的医疗保险数据库，不包括那些终末期肾病（ESRD），被确定为2年期间（1996-1997年）。确定了CHF、CKD和贫血亚组。在合并症校正的考克斯模型中检查每种疾病作为死亡率独立预测因子的作用，患者随访2年，并对死亡或ESRD进行删失。在研究人群中，61%是女性，89%是白色，7%是黑人。平均SD年龄为76.5 ± 6.9岁。无CHF、CKD或贫血患者的年死亡率为4%。贫血与8%的年死亡率相关，与CKD（8%）相同。CHF的年死亡率为13%。结论：老年CHF患者死亡风险高，合并慢性肾脏病和贫血的患者死亡风险更高。
Background: Congestive heart failure (CHF) is a common clinical problem in the elderly, yet few studies have focused on this population. In addition, information on mortality rates conferred by chronic kidney disease (CKD) and anemia in elderly patients with CHF is lacking.Methods and Results: A cohort of 1,136,201 patients in the 5% Medicare database, excluding those with end-stage renal disease (ESRD), was identified for a 2-year period (1996-1997). Subgroups with CHF, CKD, and anemia were identified. The effect of each disease as an independent predictor of mortality was examined in a comorbidity-adjusted Cox model, with patients followed for 2 years and censored for death or ESRD. In the study population, 61% were women; 89% were white and 7% were black. Mean SD age was 76.5 +/- 6.9 years. The annual mortality rate for patients with no CHF, CKD, or anemia was 4%. Anemia was associated with an annual mortality of 8%, which was the same as CKD (8%). The annual mortality for CHF was 13%. The highest annual mortality was found in patients with all 3 comorbid conditions; mortality in these patients was 23%.Conclusions: Elderly CHF patients are at high risk of death; this risk is magnified in the presence of CKD and anemia.