| Objectives To describe re-hospitalization rate and mortality in elderly patients with chronic heart failure(CHF)during two-year period after discharge,and to identify factors that affect re-hospitalization rate and mortality in elderly patients with heart failure during two-year period after discharge.Methods 152 patients with HF with heart function of NYHA degree of ? to ? from the Cardiovascular Department of the Affiliated Hospital of North China University of Science & Technology from May,2015 to May,2015,were enrolled in our observation cohort.Diagnostic criteria for heart failure include: 1)history of previous heart diseases;2)clinical manifestations of heart failure(different degrees of chest distress,breathlessness,wheezing or dyspnea,fatigue,edema,loss of appetite,sleep disorder,and physical activity limitation);3)at least one indicator of the following abnormalities of the heart disease: coronary heart disease,hypertension,ischemic cardiomyopathy,dilated cardiomyopathy,valvular heart disease;cardiac structural and functional indexes,such as chest radiography and Doppler echocardiography(LVEF < 50%;diagnostic criteria for heart failure with normal ejection fraction),myocardial perfusion scan,etc.Inclusion criteria include: 1)60 years of age or older;2)Patients with clearly-diagnosed HF by clinicians;3)Patients discharged from hospital after standardized treatment.Clinical data of patients with heart failure were collected during hospitalization,including age,gender,BMI,disease diagnosis,NYHA degrees of heart function,commonalities(hypertension,diabetes,kidney disease,chronic obstructive pulmonary disease),cardiac ultrasound measurements(ejection fraction,left atrial and left ventricular size),biochemical measurements(blood lipids,blood glucose,creatinine,hemoglobin,blood sodium);economy status,education,medication and other information.Patients were followed up every 3 months after discharge via phone and etiology and the date of re-hospitalization or death were recorded every 3 months after discharge.Self-designed questionnaire was used to collect baseline data.All the data were analyzed by SPSS17.0.The cumulative cardiogenic re-admission rate and mortality rate at each follow-up time point were calculated.Multivariate Cox regression model was used to screen the prognostic factors.P<0.05 was statistically significant.Results The re-hospitalization rate in 146 patients attributed to HF at 3,6,9,12,15,18,21and 24 months after discharge were 3.4%,10.9%,17.1%,19.2%,22.6%,26.0%,30.1% and 35.6%,respectively.The mortality were 1.4%,2.7%,3.4%,6.8%,9.6%,12.3%,15.8% and 20.5% during the same follow-up;re-hospitalization and/or mortality in elderly patients with HF were 35.6% and 20.5%.Cox regression indicates that the rate of re-admission or death in patients of over 75 years old is 2.353 times than that in patients of less or equal to 75 years old.The rate of patients with NT-pro BNP more than 1000 is 2.347 times than that with NT-pro BNP no more than 1000.The rate of patients with EF less than 0.5 is 2.105 times than that with ejection fraction more than 0.5.The rate of patients with Hb less or equal to 130g/L is 2.105 times than that with Hb more than 130g/L.Patients who did not take beta blockers are 1.961 times risky than those taking.Patients who did not take diuretics are 1.49 times risky than those taking.Conclusions Age,gender,levels of hemoglobin,NT-pro BNP and medications were the main influencing factors for re-hospitalization and/or mortality in CHF patients within 2-year. |
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