心力衰竭患者出现非酒精性肝硬化和心源性休克的 5 年趋势

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2024-09-01 DOI:10.1016/j.ajpc.2024.100814

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引用次数: 0

摘要

治疗领域心力衰竭背景在心力衰竭（HF）患者中，非酒精性肝硬化（NALC）和心源性休克的交叉出现给临床带来了巨大挑战。了解这些并发症的发展趋势对改善患者预后至关重要。本研究探讨了五年内高血压患者中 NALC 及其进展为心源性休克的趋势。方法分析了全国住院患者样本（2016-2020 年）中的数据，使用 ICD-10 编码识别出患有 NALC 的高血压患者。使用Cochran-Armitage检验进行趋势分析，并使用多变量逻辑回归对混杂因素进行调整。2016 年是比较 2020 年之前数据趋势的参照年。结果在1,372,419名HF患者中，26,435人（1.9%）患有NALC，其中1,180人（4.5%）出现心源性休克，平均年龄为65岁，男性占59.3%。2016 年，高血压患者的 NALC 发生率为 1.7%。到 2017 年，增加到 2.0%（OR 1.2，95% CI 1.20-1.31，p<0.001），2018 年为 2.2%（OR 1.3，95% CI 1.17-1.42，p<0.001），2019 年为 2.4%（OR 1.5，95% CI 1.31-1.60，p<0.001），2020 年为 2.7%（OR 1.6，95% CI 1.47-1.79，p<0.001），表明呈上升趋势（趋势 p<0.001）。2016年NALC患者的心源性休克率为3.53%，2017年增至4.32%（OR 1.2，95% CI 0.83-1.83，p=0.3），而无NALC患者的心源性休克率为3.1%，2018年为4.73%（OR 1.3，95% CI 0.85-2.1，p=0.2）与4.5%相比，2019年为6.93%（OR 1.5，95% CI 1.37-3.02，p<0.001）与5.6%相比，2020年为6.60%（OR 1.6，95% CI 1.25-2.88，p=0.003）与6.4%相比，呈现上升趋势（趋势p<0.001）。总体而言，心源性休克 OR 为 1.5 (95% CI 1.31-1.70, p<0.001)。这凸显了警惕性监测和针对性干预对有效管理高血压患者的重要性。

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A 5-YEAR TREND OF NON-ALCOHOLIC LIVER CIRRHOSIS AND CARDIOGENIC SHOCK IN HEART FAILURE PATIENTS

Therapeutic Area

Heart Failure

Background

In heart failure (HF) patients, the intersection of non-alcoholic liver cirrhosis (NALC) and cardiogenic shock poses significant clinical challenges. Understanding the trends of these complications is essential for improving patient outcomes. This study examines the trend of NALC and its progression to cardiogenic shock among HF patients over a five-year period.

Methods

Data from the National Inpatient Sample (2016-2020) were analyzed to identify HF patients with NALC using ICD-10 codes. Trends were assessed using the Cochran-Armitage test for trend analysis and multivariable logistic regression to adjust for confounding factors. The year 2016 was the reference year for comparing data trends up to 2020. Outcomes are presented as odds ratios (ORs) with 95% confidence intervals (CIs) and p-values.

Results

Out of 1,372,419 HF patients, 26,435 (1.9%) had NALC, with 1,180 (4.5%) experiencing cardiogenic shock with a mean age of 65 and predominantly male 59.3%. The rate of NALC among HF patients was 1.7% in 2016. By 2017, it increased to 2.0% (OR 1.2, 95% CI 1.20–1.31, p<0.001), 2.2% in 2018 (OR 1.3, 95% CI 1.17–1.42, p<0.001), 2.4% in 2019 (OR 1.5, 95% CI 1.31–1.60, p<0.001), and 2.7% in 2020 (OR 1.6, 95% CI 1.47–1.79, p<0.001), indicating an upward trend (trend p<0.001). Cardiogenic shock rates in patients with NALC were 3.53% in 2016, increasing to 4.32% in 2017 (OR 1.2, 95% CI 0.83–1.83, p=0.3) compared to 3.1% in patients without NALC, 4.73% in 2018 (OR 1.3, 95% CI 0.85–2.1, p=0.2) compared to 4.5%, 6.93% in 2019 (OR 1.5, 95% CI 1.37–3.02, p<0.001) compared to 5.6%, and 6.60% in 2020 (OR 1.6, 95% CI 1.25–2.88, p=0.003) compared to 6.4%, showing an increase trend (trend p<0.001). Overall, Cardiogenic shock OR was 1.5 (95% CI 1.31–1.70, p<0.001).

Conclusions

The study highlights the increasing trend of NALC and a concurrent increase in the rate of cardiogenic shock among patients with HF. This underscores the importance of vigilant monitoring and targeted intervention in effectively managing the HF population.

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来源期刊

American journal of preventive cardiology Cardiology and Cardiovascular Medicine

CiteScore

6.60

自引率

0.00%

发文量

审稿时长

76 days