Anemia and outcomes in patients with heart failure - A study from the National Heart Care Project
Anemia and outcomes in patients with heart failure - A study from the National Heart Care Project
复制标题
DOI：
10.1001/archinte.165.19.2237
复制
发表时间：
2005-10-24
影响因子：
--
通讯作者：
Krumholz, HM
中科院分区：
文献类型：
--
作者：
Kosiborod, M;Curtis, JP;Krumholz, HM
背景资料：最近的报告表明，贫血与心力衰竭（HF）患者的不良结局相关，但无法调整广泛的共病状况。因此，在这些患者中，贫血是否是一个真正独立的风险预测因子或共病的标志物尚不清楚。我们分析了来自医疗保险和医疗补助服务中心国家心脏护理项目的医疗记录，该项目是一项全国样本，共有50405名65岁及以上的患者在1998年4月1日至2008年4月1日期间入住急诊医院，主要出院诊断为HF，1999年3月31日至2000年7月1日期间，或2001年6月30日期间。进行多变量logistic回归分析，以测试是否红细胞压积水平是一个独立的预测因素的全因死亡率和HF相关的再入院在1 year.Results：在未经调整的分析，较低的红细胞压积水平与增加1年死亡率和再入院的HF。与红细胞压积大于40%至44%的患者相比，红细胞压积小于或等于24%的患者死亡风险高51%（相对风险[RR]，1.51; 95%置信区间[CI]，1.35-1.68; P
Background: Recent reports have suggested that anemia is associated with adverse outcomes in patients with heart failure (HF), but were unable to adjust for a broad range of comorbid conditions. As a result, whether anemia is a truly independent predictor of risk or a marker of comorbid illness in these patients is unknown.Methods: We analyzed medical records from the Centers for Medicare & Medicaid Services' National Heart Care Project, a national sample of 50 405 patients 65 years and older admitted to acute care hospitals with a principal discharge diagnosis of HF between April 1, 1998, and March 31, 1999, or between July 1, 2000, and June 30, 2001. Multivariable logistic regression analyses were conducted to test whether hematocrit level was an independent predictor of all-cause mortality and HF-related readmission at 1 year.Results: In unadjusted analysis, lower hematocrit levels were associated with increased 1-year mortality and readmission for HF. Compared with patients with a hematocrit greater than 40% to 44%, those with a hematocrit of 24% or less had a 51% higher risk of death (relative risk [RR], 1.51; 95% confidence interval [CI], 1.35-1.68; P