Clinical factors associated with early readmission among acutely decompensated heart failure patients.
Clinical factors associated with early readmission among acutely decompensated heart failure patients.
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DOI：
10.5114/aoms.2016.59927
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发表时间：
2016-06-01
期刊：
影响因子：
--
通讯作者：
Wright M
中科院分区：
文献类型：
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作者：
Pierre-Louis B;Rodriques S;Gorospe V;Guddati AK;Aronow WS;Ahn C;Wright M
充血性心力衰竭（CHF）是再入院的常见原因。纽约市哈莱姆医院进行了一项回顾性研究。收集了 2009 年 3 月至 2012 年 12 月期间因失代偿性 CHF 入院的 685 名连续成年患者的数据。比较了入院的 CHF 患者之间的变量，包括患者人口统计、合并症、实验室研究和药物治疗，导致早期 CHF 再入院和不导致早期 CHF 再入院。发现对早期CHF再入院具有独立显着性的临床因素包括慢性阻塞性肺疾病（比值比（OR）= 6.4）、HIV感染（OR = 3.4）、非洲裔美国人（OR = 2.2）、收缩性心力衰竭（OR = 1.9）、心房颤动（OR = 2.3）、肾小球滤过率< 30 ml/min的肾脏疾病（OR = 2.7）、药物滥用证据（OR = 1.7），出院后未接受血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂治疗（OR = 1.8）。 OR 用于开发有关早期再入院风险的评分系统。使用提议的评分系统识别因CHF住院后早期CHF再入院相关的临床因素的患者，将允许针对特别高风险的患者制定早期CHF再入院风险分层方案。
Congestive heart failure (CHF) is a common cause of hospital readmission. A retrospective study was conducted at Harlem Hospital in New York City. Data were collected for 685 consecutive adult patients admitted for decompensated CHF from March, 2009 to December, 2012. Variables including patient demographics, comorbidities, laboratory studies, and medical therapy were compared between CHF patient admissions resulting in early CHF readmission and not resulting in early CHF readmission. Clinical factors found to be independently significant for early CHF readmission included chronic obstructive pulmonary disease (odds ratio (OR) = 6.4), HIV infection (OR = 3.4), African-American ethnicity (OR = 2.2), systolic heart failure (OR = 1.9), atrial fibrillation (OR = 2.3), renal disease with glomerular filtration rate < 30 ml/min (OR = 2.7), evidence of substance abuse (OR = 1.7), and absence of angiotensin-converting enzyme inhibitors or angiotensin receptor blocker therapy after discharge (OR = 1.8). The ORs were used to develop a scoring system regarding the risk for early readmission. Identifying patients with clinical factors associated with early CHF readmission after an index hospitalization for CHF using the proposed scoring system would allow for an early CHF readmission risk stratification protocol to target particularly high-risk patients.