Outcomes of acute exacerbation of severe congestive heart failure - Quality of life, resource use, and survival
Outcomes of acute exacerbation of severe congestive heart failure - Quality of life, resource use, and survival
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DOI：
10.1001/archinte.158.10.1081
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发表时间：
1998-05-25
影响因子：
--
通讯作者：
Conners, AF
中科院分区：
文献类型：
--
作者：
Jaagosild, P;Dawson, NV;Conners, AF
背景：充血性心力衰竭(CHF)是一种常见病，医疗费用高，死亡率高。了解慢性心力衰竭患者的健康相关生活质量结果可能会指导决策，并有助于评估针对这一人群的新疗法。方法：对1390名因严重心力衰竭急性加重而住院的成人患者进行了前瞻性队列研究(纽约心脏协会III-IV级)。结果：患者年龄中位数(第25、75百分位数)为68.0岁(58.2岁，76.9岁)，男性为61.7%。出院时存活率为93.40%，180天存活率为72.9%，1年存活率为61.5%。在180天接受采访的患者中，0至100分(0分代表死亡；100分代表健康良好)的中位健康评分为60分(四分位数范围为50-80)，59.7%的患者在日常生活能力方面独立。180d时，58.2%的患者报告总体生活质量为好、非常好或极好。功能能力较差的患者死亡的可能性更大。有访谈资料的重度CHF患者在急性加重期60d和180d的健康认知有所改善。结论：重度CHF急性加重期住院患者的6个月存活率普遍较低，但存活者仍有较好的功能状态和良好的健康认知。此外，在急性加重后，健康观念有所改善。
Background: Congestive heart failure (CHF) is a common disease with high health care costs and high mortality rates. Knowledge of the health-related quality of life outcomes of CHF may guide decision making and be useful in assessing new therapies for this population.Methods: A prospective cohort study was conducted involving 1390 adult patients hospitalized with an acute exacerbation of severe CHF (New York Heart Association class III-IV). Demographic data and health-related quality of life were determined by interview; physiologic status and cost and intensity of care were determined from hospital charts.Results: The median (25th, 75th percentiles) age of patients was 68.0 (58.2, 76.9) years; 61.7% were male. Survival was 93.40%, at discharge from the index hospitalization, 72.9% at 180 days, and 61.5% at 1 year. Of patients interviewed at 180 days, the median health rating on a scale of 0 to 100 (0 indicates death; 100, excellent health) was 60 (interquartile range, 50-80), and 59.7% were independent in their activities of daily living. Overall quality of life was reported to be good, very good, or excellent in 58.2% at 180 days. Patients with worse functional capacity were more likely to die. Health perceptions among the patients with available interview data improved at 60 and 180 days after acute exacerbation of severe CHF.Conclusions: Patients hospitalized for acute exacerbation of severe CHF have a generally poor 6-month survival, but survivors retain relatively good functional status and have good health perceptions. Furthermore, health perceptions improve after the acute exacerbation.