首页> 外文期刊>European journal of heart failure: journal of the Working Group on Heart Failure of the European Society of Cardiology >Implantable device diagnostics on day of discharge identify heart failure patients at increased risk for early readmission for heart failure
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Implantable device diagnostics on day of discharge identify heart failure patients at increased risk for early readmission for heart failure

机译:出院当天的植入式设备诊断可识别出因心力衰竭而提前再次入院的风险增加的心力衰竭患者

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We hypothesized that diagnostic data in implantable devices evaluated on the day of discharge from a heart failure hospitalization (HFH) can identify patients at risk for HF readmission (HFR) within 30 days.In this retrospective analysis of four studies enrolling patients with CRT devices, we identified patients with a HFH, device data on the day of discharge, and 30-day post-discharge clinical follow-up. Four diagnostic criteria were evaluated on the discharge day: (i) intrathoracic impedance >8 Q, below reference impedance; (ii) AF burden >6 h; (iii) CRT pacing <90%; and (iv) night heart rate >80 b.p.m. Patients were considered to have higher risk for HFR if >2 criteria were met, average risk if 1 criterion was met, and lower risk if no criteria were met. A Cox proportional hazards model was used to compare the groups. The data cohort consisted of a total of 265 HFHs in 175 patients, of which 36 (14%) were followed by HFR. On the discharge day, >2 criteria were met in 43 (16% of 265 HFHs), only 1 criterion was met in 92 (35%), and none of the four criteria were met in 130 HFHs (49%); HFR rates were 28, 16, and 7%, respectively. HFH with >2 criteria met was five times more likely to have HFR compared with HFH with no criteria met (adjusted hazard ratio 5.0; 95% confidence interval 1.9-13.5, P = 0.001).Device-derived diagnostic criteria evaluated on the day of discharge identified patients at significantly higher risk of HFR.
机译:我们假设,在因心力衰竭住院(HFH)出院当天评估的植入式设备中的诊断数据可以在30天内识别出有HF再入(HFR)风险的患者。在这项回顾性分析中,对四项使用CRT设备入选患者的研究进行了回顾性分析,我们确定了患有HFH的患者,出院当天的设备数据以及出院后30天的临床随访。在出院当天评估了四个诊断标准:(i)胸内阻抗> 8 Q,低于参考阻抗; (ii)AF负荷> 6小时; (iii)CRT起搏<90%; (iv)夜间心率> 80 b.p.m.如果满足> 2个标准,则认为患者发生HFR的风险较高;如果满足1个标准,则被认为具有平均风险;如果不满足标准,则被认为具有较低的风险。使用Cox比例风险模型比较各组。数据队列包括175例患者中的265例HFH,其中36例(14%)随后是HFR。在出院当日,有43个(265个HFHs中的16%)满足了> 2个标准,92个(35%)中只有1个标准得到了满足,130个HFHs中没有满足4个标准(49%)。 HFR率分别为28、16和7%。符合> 2个标准的HFH与未符合标准的HFH相比,发生HFR的可能性高五倍(调整后的危险比5.0; 95%置信区间1.9-13.5,P = 0.001)。出院后发现患者的HFR风险明显较高。

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