Retrospective Analysis Of 1059 Hospitalized Patients With Treatment Of Chronic Systolic Heart Failure

Objective:Retrospective analysis of the clinical treatment and prognosis of 1059 hospitalized patients with chronic systolic heart failure admitted to the Affiliated Hospital of Youjiang Medical College for Nationalities.Methods:The CSHF patients who were admitted to the Affiliated Hospital of Youjiang Medical College for Nationalities from 2013.8.1 to 2018.9.30 were selected according to the Chinese CHF guidelines for diagnosisin 2014,and NYHA class II-IV CSHF patients(1059patients)were selected.Collect general information,comorbidity,cardiac function grading,auxiliary examination,clinical treatment,and prognosis who meet the criteria.According to the cases screened in the case file,we entered the electronic case system of our hospital to search for information,enter it,and set up a database by Excel table.Retrospective analysis was used to analyze cases as a whole and year by year.Results:(1)The CSHF patient’s age range was 22-107 years old and the average age was(60.66±13.09)years.There were 751 males(70.92%)and 308 females(29.08%).Among them,765 cases(72.24%)were Zhuang,267(25.21%)were Han,24(2.27%)were Yao,2(0.19%)were Yi,and 1(0.09%)were Miao.The average length of hospital stay(9.86 ± 6.57)days.The number and percentage of patients with grade II,III,and IV cardiac function were:238(22.47%),633(59.77%),and 188(17.75%).The mean ejection fraction(EF)was(28.72±6.70)%,the average left atrial systolic diameter(LASD)was(42.20±7.88)mm,and the mean left ventricular diastolic diameter(Left ventricular diastolic).The diameter,LVDD)is(63.07 ± 11.16)mm.(2)In the past 6 years,the proportion of comorbidities in CSHF patients in the region was as follows: 591 cases(55.81%)of pulmonary infection,412 cases(38.90%)of arrhythmia,372cases(35.13%)of hypertension,hyperlipemia 193 cases(18.22%),94 cases of diabetes(8.88%).(3)Drug treatment for CSHF patients in the region in the past 6 years was as follows:diuretics accounted for 93.20%;Angiotensin Converse Enzyme Inhibitor(ACEI)accounted for 71.77%;Angiotensin II blockers(Angiotensin II)Receptor blocker(ARB)accounted for10.67%;ACEI/ARB drug accounted for 77.43%;beta blocker accounted for 34.66%;aldosterone receptor antagonist(spirone)accounted for 91.03%;ACEI,beta blocker,aldosterone Receptor antagonists combined use of three drugs accounted for 27.57%;digitalis56.66%;non-digitalis positive inotropic drugs 41.64%;new drugs 6.42%,of which levosimendan 6.23%,nesilide peptide 0.19%.(4)In the past 6 years,the non-pharmacological treatment of CSHF patients in this area was102 cases(11.33%)of percutaneous coronary intervention(PCI),Cardiac resychronization therapy(CRT),Enhanced External Counterpulsation(EECP)and heart transplantation were 0(0%).(5)When analyzing the prognosis,use the number of cases in 2013-2015 as group A and the number of cases in 2015-2018 as group B for comparative analysis.The overall improvement rate of CSHF hospitalized cases was 12.65%.From the prognosis of group A and B,the improvement rate increased with period,10.06%,14.78%(P<0.05).The overall improvement rate of hospitalized cases was 83.47%,ranking first.However,in group A and group B,the improvement rate of group B was slightly lower,which was 84.49% and 82.65%(P>0.05).The unhealed rate of hospitalized patients decreased with period.Comparing the A and B groups,the unhealed rate of the B group was lower,1.05% and 0.34%(P>0.05).The mortality rate of hospitalized patients decreased significantly with the period.The mortality of group B was significantly lower in group A and group B,which were 3.77% and 1.72%(P<0.05).The rate of deterioration did not change significantly in the two years.Conclusion:(1)The proportion of CSHF patients with comorbidities in the past 6 years from high to low is: pulmonary infection,arrhythmia,hypertension,hyperlipidemia,diabetes.(2)In the past 6 years,CSHF patients still use traditional drug diuretics in their drug treatment.The aldosterone receptor antagonist(spirolactone)is used well and meets the guidelines.The use rate of ACEI,ARB,and β-blockers is still low,and there are still gaps in the ratios and guidelines for the combination of ACEI/ARB,β-blockers,and aldosterone receptor antagonists.Some patients have been treated with levosimendan and nesiritide,but the use rate is low.(3)In the past 6 years,the prognosis of CSHF patients during hospitalization had changed as,the obvious improvement rate was significantly increased,and the mortality rate decreased significantly.