急性失代偿性心力衰竭患者入院后早期步行速度与全因死亡和/或再入院之间的关系。

IF 2.9 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS European Journal of Cardiovascular Nursing Pub Date : 2024-05-28 DOI:10.1093/eurjcn/zvad092
Kohei Nozaki, Nobuaki Hamazaki, Kentaro Kamiya, Shota Uchida, Takumi Noda, Kensuke Ueno, Kazuki Hotta, Emi Maekawa, Atsuhiko Matsunaga, Minako Yamaoka-Tojo, Junya Ako
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引用次数: 0

摘要

目的:心力衰竭(HF)患者经常会出现身体功能下降,包括步行速度下降。步行速度降低与预后较差有关。然而,这些报道大多集中于稳定型心力衰竭患者,急性期步行速度与临床预后之间的关系尚不明确。因此,我们旨在研究急性失代偿性心房颤动(ADHF)患者入院后早期步行速度与临床事件之间的关系:我们对连续收治的 1391 名 ADHF 患者进行了回顾性研究。我们测量了入院后首次在病房行走超过 10 米时的步行速度,并将入院后四天内的步行速度纳入本研究。主要结果是综合事件(全因死亡和/或因高血压再次入院)。随访期为出院后一年。研究对象的中位年龄为 74 岁(四分位距[IQR]:65-80 岁),35.9% 的患者为女性。步行速度中位数为 0.70 米/秒(IQR:0.54-0.88 米/秒)。429名患者(30.8%)发生了合并事件。步行速度越快,合并事件的发生率越低(每增加 0.1 米/秒的调整后危险比为 0.951,95% 置信度为 0.951):结论:结论:入院后四天内步行速度越快,ADHF 患者的临床预后越好。结果表明,在急性期测量步行速度有助于尽早进行风险分层。
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Association between walking speed early after admission and all-cause death and/or re-admission in patients with acute decompensated heart failure.

Aims: Patients with heart failure (HF) frequently experience decreased physical function, including walking speed. Slower walking speed is associated with poorer prognosis. However, most of these reports focused on patients with stable HF, and the relationship between walking speed in acute phase and clinical outcomes is unclear. Therefore, we aimed to investigate the associations between walking speed early after admission and clinical events in patients with acute decompensated HF (ADHF).

Methods and results: We reviewed consecutive 1391 patients admitted due to ADHF. We measured walking speed the first time to walk on the ward more than 10 m after admission, and the speed within 4 days after admission was included in this study. The primary outcome was combined events (all-cause death and/or re-admission due to HF). The follow-up period was up to 1 year from the discharge. The study population had a median age of 74 years [interquartile range (IQR): 65-80 years], and 35.9% of patients were females. The median walking speed was 0.70 m/s (IQR: 0.54-0.88 m/s). Combined events occurred in 429 (30.8%) patients. Faster walking speed was independently associated with lower rate of combined events (adjusted hazard ratio per 0.1 m/s increasing: 0.951, 95% confidence interval: 0.912-0.992).

Conclusion: Faster walking speed within 4 days after admission was associated with favourable clinical outcomes in patients with ADHF. The results suggest that measuring walking speed in acute phase is useful for earlier risk stratification.

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来源期刊
European Journal of Cardiovascular Nursing
European Journal of Cardiovascular Nursing CARDIAC & CARDIOVASCULAR SYSTEMS-NURSING
CiteScore
5.10
自引率
10.30%
发文量
247
审稿时长
6-12 weeks
期刊介绍: The peer-reviewed journal of the European Society of Cardiology’s Council on Cardiovascular Nursing and Allied Professions (CCNAP) covering the broad field of cardiovascular nursing including chronic and acute care, cardiac rehabilitation, primary and secondary prevention, heart failure, acute coronary syndromes, interventional cardiology, cardiac care, and vascular nursing.
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