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首页> 外文期刊>Archives of Internal Medicine >Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE-HF.
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Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE-HF.

机译：医院因素确定为沉淀心力衰竭和临床的招生结果:发现OPTIMIZE-HF。

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BACKGROUND: Few studies have examined factors identified as contributing to heart failure (HF) hospitalization, and, to our knowledge, none has explored their relationship to length of stay and mortality. This study evaluated the association between precipitating factors identified at the time of HF hospital admission and subsequent clinical outcomes. METHODS: During 2003 to 2004, 259 US hospitals in OPTIMIZE-HF submitted data on 48 612 patients, with a prespecified subgroup of at least 10% providing 60- to 90-day follow-up data. Identifiable factors contributing to HF hospitalization were captured at admission and included ischemia, arrhythmia, nonadherence to diet or medications, pneumonia/respiratory process, hypertension, and worsening renal function. Multivariate analyses were performed for length of stay, in-hospital mortality, 60- to 90-day follow-up mortality, and death/rehospitalization. RESULTS: Mean patient age was 73.1 years, 52% of patients were female, and mean ejection fraction was 39.0%. Of 48 612 patients, 29 814 (61.3%) had 1 or more precipitating factors identified, with pneumonia/respiratory process (15.3%), ischemia (14.7%), and arrhythmia (13.5%) being most frequent. Pneumonia (odds ratio, 1.60), ischemia (1.20), and worsening renal function (1.48) were independently associated with higher in-hospital mortality, whereas uncontrolled hypertension (0.74) was associated with lower in-hospital mortality. Ischemia (1.52) and worsening renal function (1.46) were associated with a higher risk of follow-up mortality. Uncontrolled hypertension as a precipitating factor was associated with lower postdischarge death/rehospitalization (hazard ratio, 0.71). CONCLUSIONS: Precipitating factors are frequently identified in patients hospitalized for HF and are associated with clinical outcomes independent of other predictive variables. Increased attention to these factors, many of which are avoidable, is important in optimizing the management of HF. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00344513.
机译：背景:很少有研究调查的因素认定为导致心力衰竭(HF)住院治疗,据我们所知,没有探讨住院时间和他们的关系死亡率。诱发因素之间的识别高频住院和随后的时代临床结果。259年美国医院OPTIMIZE-HF提交的数据48 612名患者,指定子群的至少10%提供60 - 90天的随访数据。在入学和捕获住院治疗包括缺血、心律失常、不依从饮食或药物治疗,肺炎/呼吸过程、高血压和肾功能恶化函数。住院时间、住院死亡率,60 -90天的随访死亡死亡/再入院治疗。年龄为73.1岁,52%的患者是女性,和平均射血分数为39.0%。29岁的患者814例(61.3%)有1或更多诱发因素确定,肺炎/呼吸过程(15.3%)、缺血(14.7%)和心律失常(13.5%)最多频繁。(1.20),和肾功能恶化(1.48)独立与更高的住院死亡率,而不受控制的高血压(0.74)是降低住院死亡率。(1.46)与更高的相关函数后续死亡率的风险。高血压的诱发因素降低出院后死亡/再入院治疗(危险比0.71)。结论:诱发因素频繁确定患者对高频和住院与临床结果独立其他预测变量。注意这些因素,其中许多可避免的,优化是很重要的心力衰竭的管理。

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