目的:分析不同年龄休克指数(age shock indexes, ASI)心力衰竭住院患者的临床特征、院内治疗情况及出院后12个月结局的差异。方法:连续纳入2020年10月至2021年11月在包头医学院第二附属医院住院的18岁以上心力衰竭患者259例。收集患者基线资料,计算患者入院当天的ASI(年龄×心率/收缩压),将患者分为高ASI组和低ASI组。比较两组患者的临床特征、院内治疗情况和出院后12个月结局的差异;并分析ASI与患者出院后12个月全因死亡风险之间的相关性。结果:研究共纳入心力衰竭患者259例,低ASI组患者130例,高ASI组患者129例。高ASI组患者体重指数、收缩压、舒张压及左心室射血分数数值更低、左心室后壁更薄,脑钠肽、白细胞计数更高;口服β受体阻滞剂以及静脉使用正性肌力药物、利尿剂的患者更多(均P＜0.05)。出院后12个月,高ASI组患者发生再住院(34.9%)及全因死亡(23.3%)事件更多,12个月全因死亡风险更高(HR=3.05, 95%CI: 1.25~7.45, P=0.014)。结论:高ASI组患者和低ASI组患者的临床特征不同,住院期间进行的治疗相似。高ASI组出院12个月全因死亡风险高于低ASI组,ASI是影响心力衰竭住院患者远期预后的独立危险因素。
Objective: To analyze the clinical features, in-hospital treatment and 12-month outcomes of heart failure inpatients with different age shock indexes (ASI). Methods: A total of 259 heart failure patients aged over 18 years who were admitted in the Second Affiliated Hospital of Baotou Medical College from October 2020 to November 2021 were consecutively included in this study. The baseline data were collected and ASI (age × heart rate/systolic blood pressure) was calculated on the day of admission. Patients were divided into the high ASI (n=129) and low ASI group (n=129). Clinical features of the two groups of patients, differences in hospital treatment and outcomes of 12 months after discharge, and correlation between ASI and the risk for all-cause mortality 12 months after discharge in patients were analyzed. Results: Lower body mass index, systolic blood pressure, diastolic blood pressure and left ventricular ejection fraction value were found in the High ASI group of patients, with thinner left ventricular posterior wall and higher brain natriuretic peptide and white blood cell count. More patients in the high ASI group took β-blockers orally and used inotropes and diuretics intravenously than in the low ASI group (P＜0.05). 12 months after discharge, patients in the high ASI group had more rehospitalizations (34.9%) and all-cause deaths (23.3%), and a higher risk of all-cause death after 12 months. (HR=3.05, 95%CI: 1.25~7.45, P=0.014). Conclusion: Patients in the high ASI and low ASI groups had different clinical characteristics and similar treatments during hospitalization. The risk of all-cause death 12 months after discharge was higher in patients with high ASI than patients with low ASI. ASI was an independent risk factor for long-term prognosis of hospitalized patients with heart failure.
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