Clinical characteristics,treatment status,and prognosis analysis of 972 outpatient and inpatient heart failure patients
Objectives To understand the differences in clinical characteristics,treatment status,and prognosis between outpatient and inpatient heart failure patients in the real world.Methods A prospective,multicenter registration study was conducted to select 972 outpatient or inpatient heart failure patients from 24 different regions and levels of hospitals in China from December 2012 to November 2014.Demographic and clinical data,as well as treatment status,were collected and followed up at 1 year.The difference in medication treatment status between baseline and 1-year follow-up was compared using McNemar paired x2 test.Pearson x2 test was used to compare the differences in clinical data,treatment status,and outcomes between outpatient and inpatient patients.Results There were 610 outpatient patients(62.8％),and the proportion of outpatient patients under 65 years old was higher than that of hospitalized patients[44.9％(274/610)vs 35.1％(127/362),P＜0.05].The proportion of NYHA grade Ⅲ/Ⅳ patients was as high as 50.8％(310/610),and 92.5％(564/610)of outpatient patients had difficulty breathing while walking uphill.27.9％(170/610)of outpatient patients had jugular vein pressure greater than 6 cmH2O,and 24.3％(148/610)of outpatient patients had pulmonary moist rales.There was no significant difference in the main causes of heart failure between outpatient and inpatient patients(P=0.063),with ischemic cardiomyopathy being the main cause.At baseline,the use of beta blockers in outpatient patients was higher than that in hospitalized patients[63.0％(384/610)vs 54.4％(197/362),P＜0.05],while the use of diuretics and aldosterone receptor antagonists was lower than that in hospitalized patients[53.1％(324/610)vs 72.1％(261/362),49.5％(302/610)vs 61.3％(222/362),P＜0.05].There was no statistically significant difference in the use of ACEI/ARB between the two groups[67.4％(411/610)vs 62.4％(226/362),P＞0.05].At one-year follow-up,the use of ACEI/ARB in outpatient patients decreased[63.5％(360/567)vs 67.4％(411/610),P＜0.05],the usage rate of aldosterone receptor antagonists in hospitalized patients decreased by[50.3％(165/328)vs 61.3％(222/362),P＜0.05].The one-year all-cause mortality rate of the two groups of patients was close to[6.7％(41/610)vs 9.4％(34/362),P=0.124],The hospitalization rate for heart failure in the outpatient group was lower than that of hospitalized patients[25.4％(155/610)vs 36.5％(132/362),P＜0.05],but still＞25.0％.Conclusions Outpatient heart failure patients still have obvious symptoms and signs,and the prognosis is poor.The standardized management of outpatient heart failure patients cannot be ignored.
万方数据
维普
