将PRO纳入心衰患者预后评估:来自GISSI-HF研究的推荐

2020-02-18 BioMed数据坊 BioMed数据坊

患者报告结局(PRO)可反应心力衰竭患者自身状况,并为预后提供重要信息,然而PRO尚未作为临床常规资料进行收集。为了探讨PRO是否应该纳入心力衰竭患者的预后评估,意大利心肌梗死与心力衰竭生存注册研究(GISSI-HF)研究组采用前瞻性队列研究,对符合纳入标准的心力衰竭患者随访3.3年,从而评价心力衰竭疾病特异性PRO量表之一的堪萨斯城心肌病问卷(KCCQ)对心力衰竭患者死亡和再住院的预测价值,以对

患者报告结局(PRO)可反应心力衰竭患者自身状况,并为预后提供重要信息,然而PRO尚未作为临床常规资料进行收集。

为了探讨PRO是否应该纳入心力衰竭患者的预后评估,意大利心肌梗死与心力衰竭生存注册研究(GISSI-HF)研究组采用前瞻性队列研究,对符合纳入标准的心力衰竭患者随访3.3年,从而评价心力衰竭疾病特异性PRO量表之一的堪萨斯城心肌病问卷(KCCQ)对心力衰竭患者死亡和再住院的预测价值,以对PRO的应用提供依据。

该研究的研究对象来源于83个意大利心脏病中心,共1465例患者。纳入标准为诊断为慢性心力衰竭、NYHA II-III级、冠状动脉和非冠状动脉病因的门诊患者。由护理人员收集患者基线KCCQ,并对其死亡和再住院情况进行随访。采用Cox比例风险回归模型探讨PRO对死亡和再住院的影响。

结果表明,与理想KCCQ得分(>75)相比,低分值KCCQ<25)可预测死亡(1.8595%CI1.16-2.95)(Fig1)。而KCCQ对再住院并无预测作用。NYHA IIIII级的患者进行比较,两组患者KCCQ与结局关系的差异具有统计学意义(Table 1)。

 

Fig 1 Coxproportional hazards adjust survival curves at 3.3 years

Table 1 Mortalityand all hospital admission by NYHA class and KCCQ scores

基于研究中KCCQ对心力衰竭患者死亡的独立预测作用,研究人员建议将KCCQ作为临床心力衰竭患者管理和预后评价的常规指标。

原始出处:

Should patients perception of health status be integrated in theprognostic assessment of heart failure patients? A prospective study. Qual LifeRes, 2014, 23(1). DOI10.1007/s11136-013-0468-8

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    2020-09-01 nymo
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    2020-02-20 sunylz
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