老年综合评估对老年慢性心力衰竭患者治疗结果的影响及相关因素

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (1264 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To investigate the impact of comprehensive geriatric assessment (CGA) on the treatment outcomes of chronic heart failure (CHF), and analyze the influential factors of clinical efficacy in elderly patients. Methods: Totally 280 hospitalized patients with CHF in Fenghua People’s Hospital from January 2015 to April 2017 were recruited as participants, who were randomly divided into CGA group and control group with 140 cases each. The control group was given routine drugs, and individualized treatment was given under the guidance of CGA in the CGA group. The clinical effects of two groups were observed, and the influential factors were analyzed by logistic regression model. Results: There was no significant difference between the two groups (P>0.05) in general characteristics, the features of heart function and primary diseases at these baseline data. The total effective rate in CGA group was significantly higher than that in the control group (80.71% vs. 69.29%, P<0.05). The multivariate logistic analysis showed that the higher grade of heart function classification, larger number of complications, poorer quality of daily life, higher fall-down risk, poorer cognitive dysfunction and nutritional status were all significantly associated with the efficacy of elderly CHF (P<0.05). Conclusion: The influential factors for the prognosis of elderly CHF are numerous and complicated. The application of CGA will improve the clinical efficacy and prognosis by means of assessment of influential factors and appropriate individualized treatment under the direction of CGA.

Key words： geriatric comprehensive assessment chronic heart failure treatment outcome influential factors

Received: 07 August 2017

	Service
	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LIU Xiaofang
	LIANG Jingzhi
	ZHENG Keda.

URL:

https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2018/V48/I3/211

[1] BRAKE R, JONES I D. Chronic heart failure part 1: pathophysiology, signs and symptoms[J]. Nurs Stand, 2017, 31 (19): 54-63.
[2] 朱艳艳, 潘嘉林, 陈灵芝, 等. 慢性心力衰竭患者血浆H2松弛素的表达[J]. 温州医科大学学报, 2015, 45(1): 22-25.
[3] HUANG J, YIN H, ZHANG M, et al. Understanding the economic burden of heart failure in China: impact on disease management and resource utilization[J]. J Med Econ, 2017, 20(5): 549-553.
[4] 赵玉清, 袁桂莉, 张进顺, 等. 和肽素联合N末端B型利钠肽原评估慢性心力衰竭患者预后的价值[J]. 中国循环杂志, 2014, 29(4): 275-278.
[5] GLADMAN J R. Delivering comprehensive geriatric assessment in new settings: advice for frontline clinicians[J]. J R Coll Physicians Edinb, 2016, 46(3): 174-179.
[6] DEVORE S, PARLI S E, OYLER D R, et al. Comprehensive geriatric assessment for trauma: Operationalizing the trauma quality improvement program directive[J]. J Trauma Nurs, 2016, 23(6): 337-342.
[7] RICKARD J, BASSIOUNY M, TEDFORD R J, et al. Long-term outcomes in patients with ambulatory new york heart association class III and IV heart failure undergoing cardiac resynchronization therapy[J]. Am J Cardiol, 2015, 115(1): 82-85.
[8] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2014[J]. 中华心血管病杂志, 2014, 42(2): 98-122.
[9] 高亚南, 许永利, 陈雪丽. 老年综合评估在老年康复中的应用[J]. 中国康复理论与实践, 2013, 19(5): 452-456.
[10] 邓必勇, 崔建国, 李春坚, 等. 住院冠心病患者1 083例心理状况的调查与相关分析[J]. 中华心血管病杂志, 2010, 38(8): 702-705.
[11] 张守琳, 王世栋. 运动康复对冠心病慢性心力衰竭患者心功能的影响[J]. 中国老年学杂志, 2012, 32(23): 5121-5123.
[12] 程燕, 吴晶晶, 孙尧. 老年综合评估及干预在改善老年住院患者营养状态中的作用[J]. 中国医科大学学报, 2015, 44(10): 945-947.
[13] 卢佩颖, 沈珊珊, 陈旭娇. 老年综合评估在老年高血压患者中的应用[J]. 浙江医学, 2017, 39(6): 421-424, 427.
[14] BOLTZ M. Review: Comprehensive geriatric assessment increases a patient’s likelihood of being alive and in their own home at up to 12 months[J]. Evid Based Nurs, 2012, 15(1): 25-26.
[15] WAHLA A S, PASCUAL R, RAFEQ Z, et al. Retrospective look at change in brain natriuretic peptide values in ambulatory patients with chronic heart failure[J]. J Ayub Med Coll Abbottabad, 2012, 24(2): 3-6.
[16] 孙路路, 吕蓉, 梁涛, 等. 心力衰竭患者出院后1年内预后状况及影响因素分析[J]. 中国循环杂志, 2013, 28(2): 125-128.
[17] 尹朝霞, 肖涛, 靳晓敏, 等. 综合管理对降低慢性心力衰竭患者病死率的效果及其影响因素分析[J]. 中国全科医学, 2016, 19(35): 4392-4396.
[18] 梁世秀, 王少凡, 胡松. 老年综合评估干预对老年慢性心力衰竭住院患者预后的影响[J]. 中国老年学杂志, 2016, 36(20): 5023-5024.
[19] PRESSLER S J. Cognitive functioning and chronic heart failure: a review of the literature (2002-July 2007)[J]. J Cardiovasc Nurs, 2008, 23(3): 239-249.
[20] ESMAYEL E M, ELDARAWY M M, HASSAN M M, et al. Nutritional and functional assessment of hospitalized elderly: impact of sociodemographic variables[J]. J Aging Res, 2013, 2013: 101725.