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首页> 外文期刊>The American Journal of Cardiology >Comparison of Risk of Re-hospitalization, All-Cause Mortality, and Medical Care Resource Utilization in Patients With Heart Failure and Preserved Versus Reduced Ejection Fraction
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Comparison of Risk of Re-hospitalization, All-Cause Mortality, and Medical Care Resource Utilization in Patients With Heart Failure and Preserved Versus Reduced Ejection Fraction

机译：心力衰竭和保留射血分数降低的患者再次住院，全因死亡率和医疗资源利用风险的比较

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Because heart failure (HF) with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). are different clinical entities with differing demographic characteristics, common outcomes may occur at different rates. Comparative outcome studies have been equivocal, and studies comparing resource utilization are scant. We used an observational cohort design to study 6,513 patients hospitalized for HF who had an EF measured during the hospitalization and were discharged alive within 30 days. We excluded 677 patients with borderline EF values (41% to 49%) and categorized the remaining as HFrEF (EF <= 40%, n = 2,205) and HFpEF (EF >50%, n = 3,631). Patients were followed for up to 1 year for all-cause re-hospitalization and mortality and annualized medical resource utilization. Patients with HFrEF and HFpEF experienced similar adjusted incidence rates of re-hospitalization, but those with HFrEF had a 39% increased risk of mortality at 30 days (rate ratio 1.39, 95% confidence interval 1.10 to 1.76) and 25% greater risk at 1 year (rate ratio1.25, 95% confidence interval 1.12 to 1.41). After adjustment for covariates, patients with HFpEF incurred significantly more annualized outpatient visits (21.5 vs 20.1, p = 0.002) and emergency room visits (3.24 vs 2.94, p = 0.002) than those with HFrEF, but absolute differences were small. High inpatient and pharmacy utilization did not differ. Our. study suggests that whether a patient has HFrEF or HFpEF has little bearing on risk of re-hospitalization or impatient resource utilization in the year after an HF hospitalization. Both groups experienced high mortality, but those with HFrEF had greater risk. In conclusion, from the standpoint of resource use, HF can be considered a single entity. (C) 2015 Elsevier Inc. All rights reserved.
机译：因为心力衰竭（HF）的射血分数（HFrEF）降低而射血分数（HFpEF）保持不变。是具有不同人口统计学特征的不同临床实体，共同结果可能以不同的发生率发生。比较结果研究一直是模棱两可的，比较资源利用的研究很少。我们使用观察性队列设计研究了6,513例因心力衰竭住院的患者，他们在住院期间测量了EF，并在30天内活着出院。我们排除了677例临界EF值（41％至49％）的患者，并将其余患者分为HFrEF（EF <= 40％，n = 2,205）和HFpEF（EF> 50％，n = 3,631）。对患者进行长达1年的全因住院和死亡率随访以及每年的医疗资源利用情况。 HFrEF和HFpEF的患者再次住院的调整后发生率相似，但HFrEF的患者在30天时的死亡风险增加39％（比率1.39，95％的置信区间1.10至1.76），在1天时的风险增加25％。年（比率1.25，95％置信区间1.12至1.41）。校正协变量后，HFpEF患者的年度门诊次数（21.5 vs 20.1，p = 0.002）和急诊室就诊次数（3.24 vs 2.94，p = 0.002）比HFrEF患者大得多，但绝对差异很小。住院率和药房利用率高无差异。我们的。研究表明，有HFrEF或HFpEF的患者在HF住院后的一年中，对再次住院或没有耐心使用资源的风险影响不大。两组的死亡率都很高，但是HFrEF组的风险更高。总之，从资源使用的角度来看，HF可以被视为单个实体。 （C）2015 Elsevier Inc.保留所有权利。

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