Janine Beezer, Andrew L Clark, Adam Todd, Andrew Kingston, John Casement, Lucy Pages, Andrew Husband
{"title":"心力衰竭患者首次入院时的多药治疗:PULSE队列的基线结果","authors":"Janine Beezer, Andrew L Clark, Adam Todd, Andrew Kingston, John Casement, Lucy Pages, Andrew Husband","doi":"10.1093/ehjqcco/qcaf032","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To define and characterise polypharmacy in people with heart failure.</p><p><strong>Methods: </strong>The PULSE dataset is a bespoke single centre, retrospective, longitudinal, observational cohort database of patients hospitalised for heart failure, capturing data from the first heart failure admission through to death or end of data collection, including all subsequent admissions. First admission with heart failure was used to define baseline polypharmacy.</p><p><strong>Results: </strong>There were 660 patients included in the dataset, 55.6% male, mean age 76.1 (± SD12.3). Median number of medications on admission was 9 and on discharge 10 (25th-75th centile 7-12). Polypharmacy prevalence was 87.3% on admission, increasing at discharge to 95.1% (p<0.001). Mean medication complexity index score increased from 28.5 (±SD 14.9) at admission to 31.8 (± 14.1) at discharge; (p<0.001). Number of medications on admission increased with increasing age (p<0.001), higher Charlson Comorbidity Index (p<0.001), numerically more comorbidities (p<0.001), higher clinical frailty scale (p<0.001), longer length of stay (p=0.03), worse New York Heart Association class of symptoms (p=0.04) and a diagnosis of heart failure with preserved ejection fraction compared to heart failure with reduced ejection fraction (p=0.002). Cardiovascular medications contributed 50% of medications. Prescribing of heart failure medications reduced with increased polypharmacy.</p><p><strong>Conclusion: </strong>Polypharmacy is common on first admission to hospital for people with heart failure. More medications at admission is associated with increasing age, co-morbidity, and frailty. People with polypharmacy are more likely to have a heart failure with preserved ejection fraction diagnosis, have worse symptoms and a longer hospital stay.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":""},"PeriodicalIF":4.8000,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Polypharmacy on first admission to hospital for people with heart failure: baseline findings from the PULSE cohort.\",\"authors\":\"Janine Beezer, Andrew L Clark, Adam Todd, Andrew Kingston, John Casement, Lucy Pages, Andrew Husband\",\"doi\":\"10.1093/ehjqcco/qcaf032\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To define and characterise polypharmacy in people with heart failure.</p><p><strong>Methods: </strong>The PULSE dataset is a bespoke single centre, retrospective, longitudinal, observational cohort database of patients hospitalised for heart failure, capturing data from the first heart failure admission through to death or end of data collection, including all subsequent admissions. First admission with heart failure was used to define baseline polypharmacy.</p><p><strong>Results: </strong>There were 660 patients included in the dataset, 55.6% male, mean age 76.1 (± SD12.3). Median number of medications on admission was 9 and on discharge 10 (25th-75th centile 7-12). Polypharmacy prevalence was 87.3% on admission, increasing at discharge to 95.1% (p<0.001). Mean medication complexity index score increased from 28.5 (±SD 14.9) at admission to 31.8 (± 14.1) at discharge; (p<0.001). Number of medications on admission increased with increasing age (p<0.001), higher Charlson Comorbidity Index (p<0.001), numerically more comorbidities (p<0.001), higher clinical frailty scale (p<0.001), longer length of stay (p=0.03), worse New York Heart Association class of symptoms (p=0.04) and a diagnosis of heart failure with preserved ejection fraction compared to heart failure with reduced ejection fraction (p=0.002). Cardiovascular medications contributed 50% of medications. Prescribing of heart failure medications reduced with increased polypharmacy.</p><p><strong>Conclusion: </strong>Polypharmacy is common on first admission to hospital for people with heart failure. More medications at admission is associated with increasing age, co-morbidity, and frailty. People with polypharmacy are more likely to have a heart failure with preserved ejection fraction diagnosis, have worse symptoms and a longer hospital stay.</p>\",\"PeriodicalId\":11869,\"journal\":{\"name\":\"European Heart Journal - Quality of Care and Clinical Outcomes\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-05-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Heart Journal - Quality of Care and Clinical Outcomes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ehjqcco/qcaf032\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Quality of Care and Clinical Outcomes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjqcco/qcaf032","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Polypharmacy on first admission to hospital for people with heart failure: baseline findings from the PULSE cohort.
Aim: To define and characterise polypharmacy in people with heart failure.
Methods: The PULSE dataset is a bespoke single centre, retrospective, longitudinal, observational cohort database of patients hospitalised for heart failure, capturing data from the first heart failure admission through to death or end of data collection, including all subsequent admissions. First admission with heart failure was used to define baseline polypharmacy.
Results: There were 660 patients included in the dataset, 55.6% male, mean age 76.1 (± SD12.3). Median number of medications on admission was 9 and on discharge 10 (25th-75th centile 7-12). Polypharmacy prevalence was 87.3% on admission, increasing at discharge to 95.1% (p<0.001). Mean medication complexity index score increased from 28.5 (±SD 14.9) at admission to 31.8 (± 14.1) at discharge; (p<0.001). Number of medications on admission increased with increasing age (p<0.001), higher Charlson Comorbidity Index (p<0.001), numerically more comorbidities (p<0.001), higher clinical frailty scale (p<0.001), longer length of stay (p=0.03), worse New York Heart Association class of symptoms (p=0.04) and a diagnosis of heart failure with preserved ejection fraction compared to heart failure with reduced ejection fraction (p=0.002). Cardiovascular medications contributed 50% of medications. Prescribing of heart failure medications reduced with increased polypharmacy.
Conclusion: Polypharmacy is common on first admission to hospital for people with heart failure. More medications at admission is associated with increasing age, co-morbidity, and frailty. People with polypharmacy are more likely to have a heart failure with preserved ejection fraction diagnosis, have worse symptoms and a longer hospital stay.
期刊介绍:
European Heart Journal - Quality of Care & Clinical Outcomes is an English language, peer-reviewed journal dedicated to publishing cardiovascular outcomes research. It serves as an official journal of the European Society of Cardiology and maintains a close alliance with the European Heart Health Institute. The journal disseminates original research and topical reviews contributed by health scientists globally, with a focus on the quality of care and its impact on cardiovascular outcomes at the hospital, national, and international levels. It provides a platform for presenting the most outstanding cardiovascular outcomes research to influence cardiovascular public health policy on a global scale. Additionally, the journal aims to motivate young investigators and foster the growth of the outcomes research community.