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Prognostic Impact of Blood Urea Nitrogen Changes During Hospitalization in Patients With Acute Heart Failure Syndrome

机译:急性心力衰竭综合征住院期间血尿素氮变化对预后的影响

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Background: ?Elevated blood urea nitrogen (BUN) observed in patients hospitalized for acute heart failure syndrome (AHFS) may represent increased neurohumoral activation. The purpose of this study was to examine the prognostic impact of BUN changes during hospitalization on the long-term prognosis of AHFS patients. Methods and Results: ?The Tohoku Acute Heart Failure Registry (n=497) is a multicenter retrospective cohort study enrolling AHFS patients who were admitted in 2007. The 337 survivors (mean age, 76 years; 52% male) were divided into 3 groups according to tertiles of BUN change during hospitalization: Decreased (D-BUN, ΔBUN (BUN level at discharge–BUN level at hospitalization) ≤–1.63mg/dl, n=112); Unchanged (U-BUN, ΔBUN –1.64 to 5.73mg/dl, n=113); Increased (I-BUN, ΔBUN >5.73mg/dl, n=112). The D-BUN group had higher prevalence of lowest glomerular filtration rate during hospitalization, whereas the I-BUN group had higher systolic blood pressure. During a median follow-up period of 2.3 years after discharge, the Kaplan-Meier curve showed that D-BUN and I-BUN had worse prognosis compared with U-BUN. Multivariable logistic model showed that all-cause death was more frequent in I-BUN (hazard ratio, 2.94; 95% confidence interval, 1.51–5.73; P
机译:背景:?住院治疗急性心力衰竭综合征(AHFS)的患者血尿素氮(BUN)升高可能表示神经体液激活增加。这项研究的目的是检查住院期间BUN变化对AHFS患者的长期预后的预后影响。方法和结果:Tohoku急性心力衰竭登记处(n = 497)是一项多中心回顾性队列研究,纳入了2007年入院的AHFS患者。337名幸存者(平均年龄76岁;男性52%)分为3组。根据住院期间BUN变化的三分位数:降低(D-BUN,ΔBUN(出院时BUN水平-住院时BUN水平)≤–1.63mg / dl,n = 112);不变(U-BUN,ΔBUN–1.64至5.73mg / dl,n = 113);增加(I-BUN,ΔBUN> 5.73mg / dl,n = 112)。 D-BUN组住院期间最低肾小球滤过率的患病率较高,而I-BUN组收缩期血压较高。在出院后2.3年的中位随访期间,Kaplan-Meier曲线显示D-BUN和I-BUN的预后比U-BUN差。多变量logistic模型显示,I-BUN中全因死亡更为频繁(危险比2.94; 95%置信区间1.51-5.73; P

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