並列タイトル等日本における非代償性急性心不全患者の30日および90日以内の心不全再入院の発生率と臨床的意義 : NARA-HF研究より
一般注記type:Thesis
Background: Countermeasure development for early rehospitalization for heart failure (re-HHF) is an urgent and important issue in Western countries and Japan.Methods and Results:Of 1,074 consecutive NARA-HF study participants with acute decompensated HF admitted to hospital as an emergency between January 2007 and December 2016, we excluded 291 without follow-up data, who died in hospital, or who had previous HF-related hospitalizations, leaving 783 in the analysis. During the median follow-up period of 895 days, 241 patients were re-admitted for HF. The incidence of re-HHF was the highest within the first 30 days of discharge (3.3% [26 patients]) and remained high until 90 days, after which it decreased sharply. Within 90 days of discharge, 63 (8.0%) patients were re-admitted. Kaplan-Meier analysis revealed that patients with 90-day re-HHF had worse prognoses than those without 90-day re-HHF in terms of all-cause death (hazard ratio [HR] 2.321, 95% confidence interval [CI] 1.654-3.174; P<0.001) and cardiovascular death (HR 3.396, 95% CI 2.153-5.145; P<0.001). Multivariate analysis indicated that only male sex was an independent predictor of 90-day re-HHF. Conclusions: The incidence of early re-HHF was lower in Japan than in Western countries. Its predictors are not related to the clinical factors of HF, indicating that a new comprehensive approach might be needed to prevent early re-HHF.
博士（医学）・甲第735号・令和2年3月16日
日本循環器学会の許諾を得て登録（2020年9月2日付）
ジャーナル公式サイト（日本循環器学会HP内）：https://www.j-circ.or.jp/journal/
公開サイト（J-STAGE）：https://www.jstage.jst.go.jp/browse/circj/
identifier:Circulation journal Vol.84 No.2 p.194-202 (2020 Jan)
identifier:13469843
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3726
identifier:Circulation journal, 84(2): 194-202
DOIinfo:doi/10.1253/circj.CJ-19-0620
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