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[1]陈阳希,张兴虎,杨翔,等.Charlson共病指数与慢性心力衰竭患者预后的相关性研究[J].医学研究与战创伤救治(原医学研究生学报),2020,22(2):124-128.[doi:10.3969/j.issn.1672-271X.2020.02.003]
　CHEN Yang xi,ZHANG Xing hu,YANG Xiang,et al.The correlation between Charlson comorbidity index and clinical outcome in patients with chronic heart failure[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(2):124-128.[doi:10.3969/j.issn.1672-271X.2020.02.003]
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Charlson共病指数与慢性心力衰竭患者预后的相关性研究()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第22卷
期数:
2020年2期
页码:
124-128
栏目:
临床研究
出版日期:
2020-03-11

文章信息/Info

Title:
The correlation between Charlson comorbidity index and clinical outcome in patients with chronic heart failure
作者:
陈阳希; 张兴虎; 杨翔; 张瑗; 贡歌; 万文辉
作者单位：210002 南京，东部战区总医院（原南京军区南京总医院）干部病房一科（陈阳希、张兴虎、杨翔、张瑗、贡歌、万文辉）
Author(s):
CHEN Yangxi; ZHANG Xinghu;  YANG Xiang;  ZHANG Yuan;  GONG Ge;  WAN Wenhui
（Department of Geriatrics, General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu，China）
关键词:
共病指数; 慢性病; 慢性心力衰竭; 预后
Keywords:
comorbidity index;  chronic disease;  chronic heart failure;  clinical outcome
分类号:
R541
DOI:
10.3969/j.issn.1672-271X.2020.02.003
文献标志码:
A
摘要:
目的探讨Charlson共病指数（CCI）与慢性心力衰竭（CHF）患者预后的相关性。方法回顾性分析2015年1月至12月东部战区总医院心内科及老年病研究中心因CHF住院的240例患者临床资料，计算CCI，以CCI≤2分定义为低共病组，CCI＞2分定义为高共病组。随访至2017年12月，单因素和多因素Cox回归分析CCI对CHF预后的独立预测作用。结果240例患者中，164例患者有1种或1种以上的共病，其中低共病组171例、高共病组69例。高共病组较低共病组全因病死率[33.85% vs 13.07%，P＜0.001]、心源性病死率[15.38% vs 6.54%，P=0.035]、心衰再住院率[47.69% vs 29.41%，P=0.008]高。 与低共病组患者相比，高共病组患者2年累积生存率低（logrank检验χ2=10.547，P＜0.05），心源性病死率高（logrank检验χ2=4.972，P＜0.05）。多因素Cox比例风险回归模型分析中，CCI评分是CHF患者全因死亡、心源性死亡的独立危险因素(P＜0.05），HR（95%CI）分别是1.301（1.132～1.494）、1.363（1.118～1.662）。结论CCI评分是CHF患者预后不良的独立预测因素。
Abstract:
Objective To investigate the application of Charlson comorbidity index on patients with chronic heart failure(CHF).MethodsA retrospective cohort study of patients was admitted for chronic heart failure between January 2015 and December 2015 in department of geriatric and cardiology of General Hospital of Eastern Theater Command. Charlson comorbidity index as a tool to evaluate multimorbidity. We analyzed two groups: low(CCI≤2) and high (CCI＞2) comorbidity. Follow up to December 2017, multivariate analyses to evaluate the hazard ratio(HR) between CCI score and prognosis were performed using Cox proportional hazard regression models.ResultsAmong 240 patients, 164, 171, and 69 cases had one or more comorbidity, CCI≤2, and a CCI＞2, respectively. High comorbidity group had higher allcause mortality rate[33.85% vs 13.07%,P＜0.001], cardiaccause mortality [15.38% vs 6.54%,P=0.035]and HF readmission[47.69% vs 29.41%,P=0.008]than the low comorbidity group. KaplanMeier survival curve presented that patients with high comorbidities had lower 2 years accumulative survival rate than those with low comorbidities (logrank test χ2=10.547，P＜0.05), and higher cardiaccause mortality(logrank test χ2=4.972，P＜0.05). Cox multivariate analysis identified CCI as an independent risk factor for allcause mortality and cardiaccause mortality(P＜0.05), that showed HR(95%CI) were 1.301(1.132-1.494); 1.363(1.118-1.662).ConclusionHigher CCI is an independent predictor of poor prognosis of CHF patients.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81701890）；全军保健专项基金资助课题（13BJZ11,17BJZ17）
更新日期/Last Update: 2020-03-11