经皮冠状动脉介入治疗后再入院的发生率及预后。

IF 2.5 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology journal Pub Date : 2023-01-01 Epub Date: 2022-12-13 DOI:10.5603/CJ.a2022.0117
Alfonso Freites, Lorenzo Hernando, Pablo Salinas, Ester Cánovas, Adriana de la Rosa, Javier Alonso, Roberto Del Castillo, Alberto Núñez, Javier Botas
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引用次数: 1

摘要

背景:经皮冠状动脉介入治疗(PCI)后早期再入院(<30天)与预后较差有关,但对晚期再入院的原因和后果知之甚少。本研究的目的是确定PCI术后>1<12个月再次入院(晚期再次入院)的患者的发生率、原因和预后。方法:对743名连续PCI术后患者进行单中心回顾性队列研究。通过查看患者的电子医疗记录以及在1年和随访结束时进行的标准化电话访谈来收集患者特征和随访数据。结果:743名患者中,224名(30.14%)在PCI后1-12个月再次入院,109名因胸痛(48.66%),其他原因115例(51.34%)。再次入院与较低的生存率相关,24个月时为77.6%对98.3%,36个月时73.5%对97.6%(p<0.001)。晚期再次入院的单变量预测因素为高血压、老年、慢性肾脏疾病、左心室射血分数较低和基线血红蛋白浓度较低。只有基线血红蛋白浓度是延迟再入院的独立预测因素(比值比:0.867,95%置信区间:0.778-0.966,p=0.01)。与其他原因相比,重新诊断胸痛的死亡率较低,36个月时的生存率为90.2%对50%(p<0.001)。结论:PCI后延迟住院与预后较差有关,并与患者合并症有关。胸痛的再次入院是常见的,并且被描述为更有利的预后,类似于未再次入院的患者。一个现成的参数,基线贫血,是晚期再入院的主要预测因素。
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Incidence and prognosis of late readmission after percutaneous coronary intervention.

Background: Early readmission (< 30 days) after percutaneous coronary intervention (PCI) is associated with a worse prognosis, but little is known regarding the causes and consequences of late readmission. The aim of the present study was to determine the incidence, causes, and prognosis of patients readmitted > 1 < 12-months after PCI (late readmission).

Methods: Single-center retrospective cohort study of 743 consecutive post-PCI patients. Patient characteristics and follow-up data were collected by reviewing their electronic medical records and from standardized telephone interviews performed at 1 year and at the end of follow-up.

Results: Of the 743 patients, 224 (30.14%) were readmitted 1-12 months after PCI, 109 due to chest pain (48.66%), and 115 for other reasons (51.34%). Hospital readmission was associated with lower survival rates of 77.6% vs. 98.3% at 24 months and 73.5% vs. 97.6% at 36 months (p < 0.001). Univariate predictors for late readmission were hypertension, older age, chronic kidney disease, lower left ventricular ejection fraction, and lower baseline hemoglobin concentration. Only baseline hemoglobin concentration was an independent predictor of late readmission (odds ratio: 0.867, 95% confidence interval: 0.778-0.966, p = 0.01). Readmission for chest pain portrayed a lower mortality rate compared to other causes, with survival rates of 90.2% vs. 50% at 36 months (p < 0.001).

Conclusions: Late hospital readmission after PCI is associated with a worse prognosis and is related to patient comorbidities. Readmission for chest pain is common and portrayed a more favorable prognosis, similar to patients not readmitted. A readily available parameter, baseline anemia, was the main predictor of late readmission.

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来源期刊
Cardiology journal
Cardiology journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.10
自引率
10.30%
发文量
188
审稿时长
4-8 weeks
期刊介绍: Cardiology Journal is a scientific, peer-reviewed journal covering a broad spectrum of topics in cardiology. The journal has been published since 1994 and over the years it has become an internationally recognized journal of cardiological and medical community. Cardiology Journal is the journal for practicing cardiologists, researchers, and young trainees benefiting from broad spectrum of useful educational content.
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