在初级医疗机构接受治疗的心力衰竭患者中，贫血、住院治疗和全因死亡率之间的关系：瑞典心力衰竭登记分析。

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics Pub Date : 2024-09-26 DOI:10.1016/j.archger.2024.105645

Anna Ugarph-Morawski , Per Wändell , Lina Benson , Gianluigi Savarese , Lars H Lund , Ulf Dahlström , Björn Eriksson , Magnus Edner

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引用次数: 0

摘要

背景：许多心力衰竭（HF）患者都在基层医疗机构接受治疗，合并症很常见。贫血是一种常见的合并症。本研究旨在评估初级医疗机构中患有贫血的心力衰竭患者的患病率、合并症和预后：方法：我们将全国范围内的瑞典高血压登记册中的 9300 名初级医疗患者的数据与其他瑞典国家登记册数据进行了关联。我们建立了一个以贫血为因变量的多变量逻辑回归模型。多变量考克斯比例危险回归分析用于建立事件发生时间模型：中位年龄（IQR）为 81（74-86）岁，45% 的患者为女性。共有 2852 人（30.7%）患有贫血。男性、年龄≥75 岁者和肾功能不全者更容易出现贫血。在没有贫血和患有贫血的患者中，分别有 695 人（10.8%）和 520 人（18.2%）患有癌症。癌症与贫血密切相关（OR 1.5，95 % CI 1.3-1.7）。其他与贫血明显相关的合并症有外周动脉疾病（OR 1.39，95 % CI 1.18-1.65）、糖尿病（OR 1.29，95 % CI 1.16-1.44）和肝病（OR 1.64，95 % CI 1.09-2.46）。如果存在贫血，预后会更差。全因住院风险较高（调整后 HR 1.3，95 % CI 1.2-1.4），全因死亡风险也较高（调整后 HR 1.4，95 % CI 1.3-1.5）：结论：贫血在初级保健的高血压患者中很常见。结论：贫血在基层医疗机构的高血压患者中很常见，它与预后不良和合并症（尤其是癌症）有关。

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The association between anemia, hospitalization, and all-cause mortality in patients with heart failure managed in primary care: An analysis of the Swedish heart failure registry

Background

Many patients with heart failure (HF) are managed in primary care, and comorbidities are common. Anemia is one frequent comorbidity. The aim of this study was to assess the prevalence, comorbidities, and prognosis of HF patients in primary care who have anemia.

Method

We linked data on 9300 patients managed in primary care from the nationwide SwedeHF registry with other Swedish national register data. A multivariable logistic regression model with anemia as a dependent variable was performed. Multivariate Cox proportional hazards regression analysis was used to model the time to event.

Results

The median age (IQR) was 81 (74–86) years, and 45 % of the patients were female. A total of 2852 (30.7 %) had anemia. Anemia was more common in men, in those ≥75 years, and in those with kidney dysfunction. A total of 695 (10.8 %) of patients without and 520 (18.2 %) with anemia had cancer. Cancer was independently associated with anemia (OR 1.5, 95 % CI 1.3–1.7). Other comorbidities significantly associated with anemia were peripheral artery disease (OR 1.39, 95 % CI 1.18–1.65), diabetes (OR 1.29, 95 % CI 1.16–1.44), and liver disease (OR 1.64, 95 % CI 1.09–2.46). If anemia was present, prognosis was worse. Risk of all-cause hospitalization was higher (adjusted HR 1.3, 95 % CI 1.2–1.4), as was risk of all-cause mortality (adjusted HR 1.4, 95 % CI 1.3–1.5).

Conclusions

Anemia is common in primary care patients with HF. It is associated with worse prognosis and comorbidities, most notably cancer.

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来源期刊

Archives of gerontology and geriatrics 医学-老年医学

CiteScore

7.30

自引率

5.00%

发文量

198

审稿时长

16 days

期刊介绍： Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published. Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.