| Objective:(1)To acquire the re-hospitalization rate and the death rate of the chronic heart failure in part region of Hunan province.(2)To understand the multiple factors that related to re-hospitalization rate by researching and comparing the clinical features of chronic heart failure in part region of Hunan province.Methods:Data were collected conveniently on 514 patients with a primary diagnosis of HF who were enrolled from six participating hospitals of Hunan province from March to September 2015.HF patients enrolled in this research were followed on survival condition including re-hospitalization and death month by month for 1 year,then the re-hospitalization rate and mortality rate of 1 month,3 months,6 months,12 months would be calculated,and apply the Kaplan-Meier method to assess the related factors.Results:(1)There are 514 hospitalized heart failure patients enrolled and followed-up for 1 year,including 274 males and 240 females,the mean age is 67.5±12.6;Common comorbidities included coronary heart disease(53.1%)?hypertension(52.7%)?arrhythmia(48.2%)?diabetes(26.5%),the mean time for diagnosis are 3.50 ±4.57 years,60.3%heart failure patients have been to hospital for more than twice,the median length of hospital stay are 10.7 ±8.65 days,average cure spending is 13462±18253RMB.(2)271 HFpEF patients were enrolled in this study,female occupies 55%,the mean age is 70.1 ± 12.1,comorbidities include coronary heart disease(64.3%)?hypertension(58.3%)?arrhythmia(52.6%),when compare to HFrEF,whose mean age is 64.6±12.6,and female occupies37.4%,comorbidities include coronary heart disease(38.4%)?hypertension(46.4%)?arrhythmia(43.2%),the P value shows difference.(3)For patients with chronic heart failure,the single utilization rate of the ACEI/ARB type medicine(Renin angiotensin converting enzyme inhibitors/Angiotensin receptor blockers)ranges from 31.3%?81.1%,the average single utilization rate is 73%,the single utilization rate of the ?blockers ranges from 29.2%-70.5%,the average single utilization rate is59.5%,the single utilization rate of the spirolactone ranges from 56.8%?82%,the average single utilization rate is 73.3%,the simultaneous utilization rate ranges from 6.3%?48.The utilization rate of digitalis ranges from 13.8%?70.1%,the average utilization rate is 45.3%,the average utilization rate of vasoactive drugs like sodium nitroprussiate?nitrates is 56.8%?70.2%,the average rate of CABG?PCI?CRT/ICD is 0.4%?2.5%?0.6%.(4)The re-hospitalization rate for 1 month,3 months,6 months and 12 months is 10%?26%?42%and 52%,and the death rate is 3%?5%?9%and 12%(5)Kaplan-Meier survival curve comparison shows,there is an obvious calculous difference in the living limit comparison in diagnosis year,(Log-rank x2=3.992,P=0.046)n atrial fibrillation(Log-rank x 2=62.943,P=0.000),wheras the gender(Log-rank x 2=1.598,P=0.206)?age(Log-rank x2=1.135,P=0.287)?habitat(Log-rank x2=0.665,P=0.415)?working condition(Log-rank x2=1.489,P=0.222)?living condition(Log-rank x2=.0.128,P=0.720)?etiology(Log-rank x2=3.708,P=0.447)?heart function(Log-rank x2=1.988,P=0.159)?EF value(Log-rank x 2=0.387,P=0.534)?BNP level(Log-rank x2=3.294,P=0.07)?potassium(Log-rank x2=1.241,P=0.538)?sodium(Log-rank x2=1.220,P=0.269)don't have calculous differences?Conclusions:(1)The re-hospitalization rate for 1 month,3 months,6 months and 12 months is 10%?26%?42%and 52%,and the death rate is 3%?5%?9%and 12%respectively.,the early postdischarge period has been terme vulnerable phase.(2)atrial fibrillation,diagnosis year are the main factors influencing the re-hospitalization rate of the chronic heart failure.(3)CHF patients are more common in men,common comorbidities include coronary heart disease,hypertension,arrhythmia,and the HFpEF hospitalized patients are more common women,more inclined to conbined coronary heart disease,hypertension,arrhythmia.(4)The simultaneous utilization rate of the ACEI/ARB type medicine,?retarder and spirolactone and device implantation are lower. |
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