9-Year Trend in the Management of Acute Heart Failure in Japan: A Report From the National Consortium of Acute Heart Failure Registries.
9-Year Trend in the Management of Acute Heart Failure in Japan: A Report From the National Consortium of Acute Heart Failure Registries.
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DOI：
10.1161/jaha.118.008687
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发表时间：
2018-09-18
影响因子：
5.4
通讯作者：
Matsue Y
中科院分区：
文献类型：
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作者：
Shiraishi Y;Kohsaka S;Sato N;Takano T;Kitai T;Yoshikawa T;Matsue Y
急性心力衰竭（AHF）是一种异质性疾病，其特征和管理模式因地区而异。此外，西方国家以外的AHF证据有限。国家急性心力衰竭登记研究联盟的一个项目旨在评价日本9年以上AHF患者的患者背景、院内管理模式和长期结局随时间推移的趋势。2007年至2015年期间，从3个大规模高质量AHF登记研究（ATTEND/WET‐HF/REALITY‐AHF）中收集了AHF患者的登记研究数据。预定义的终点是年龄、性别和临床结局随时间的趋势，包括短期和长期死亡率和心力衰竭再入院。最终数据集包括9075例AHF患者。除患者年龄外，未观察到患者背景和实验室检查结果（例如贫血或肾功能）的显著差异;平均年龄在9年内显著增加（71.6-77.0岁;趋势P <0.001）。相反，住院时间缩短（平均26-16天）。这些变化与院内死亡率（4.7-7.5%）或30天心力衰竭再入院率（4.8-5.4%）以及1年死亡率和心力衰竭再入院率（分别为20.1-23.3%和23.6- 26.2%）无关。尽管患者年龄增加，但9年期间AHF患者的住院时间缩短。然而，短期和长期结局似乎不受影响;需要持续努力监测AHF患者的临床结局。
Acute heart failure (AHF) is a heterogeneous condition, and its characteristics and management patterns differ by region. Furthermore, limited evidence is available on AHF outside of Western countries. A project by the National Consortium of Acute Heart Failure Registries was designed to evaluate the trends over time in patient backgrounds, in‐hospital management patterns, and long‐term outcomes of patients with AHF over 9 years in Japan. Between 2007 and 2015, registry data for patients with AHF were collected from 3 large‐scale quality AHF registries (ATTEND/WET‐HF/REALITY‐AHF). Predefined end points were trends over time in age, sex, and clinical outcomes, including short‐ and long‐term mortality and readmission for heart failure. The final data set consisted of 9075 patients with AHF. No significant differences in patient backgrounds and laboratory findings (eg, anemia or renal function) were observed, with the exception of patient age; mean age became substantially higher over 9 years (71.6–77.0 years; P for trend, <0.001). On the contrary, length of hospital stay became shorter (mean, 26–16 days). These changes were not associated with in‐hospital mortality (4.7–7.5%) or 30‐day heart failure readmission rate (4.8–5.4%), as well as 1‐year mortality and heart failure readmission rate (20.1–23.3% and 23.6–26.2%, respectively). Length of hospital stay in patients with AHF shortened over the 9‐year period despite the increasing age of the patients. However, short‐ and long‐term outcomes do not seem to be affected; continuous efforts to monitor clinical outcomes in patients with AHF are needed.