Ⅲ型心肾综合征患者1年死亡率及相关危险因素分析

One-year mortality and risk factors in type 3 cardiorenal syndrome: a retrospective study

摘要:

目的 评估Ⅲ型心肾综合征患者1年死亡风险因素。方法 2014年1月—2017年12月从济大学附属同济医院肾内科筛选出166例符合Ⅲ型心肾综合征诊断的资料完整的患者，回顾患者一般资料、病史、实验室指标，根据患者1年内是否存活分成存活组与死亡组，同时比较2组资料，并运用多因素Logistic回归分析预测患者1年内死亡风险的独立危险因素。结果 166名患者中，存活118例，死亡48例，死亡率为40.68%。单因素分析显示： 年龄[68(58,81)vs 81(73,85),P=0.001]、入院时收缩压[146(130,173)vs 131(120,148),P=0.002]、重复住院[3(0,5)vs 1(0,3),P=0.003]、C反应蛋白[12(3.75,34.25)vs 22(6,80.5),P=0.018]与1年内死亡风险相关，进一步通过多因素Logistic回归分析发现入院时收缩压（P=0.025, OR=0.973）是预测Ⅲ型心肾综合征患者1年死亡风险的独立危险因素。结论 Ⅲ型心肾综合征死亡率高达40.68%；入院时收缩压是患者1年死亡的独立危险因素。

Abstract:

Objective To analysis one-year mortality and risk factors of type 3 cardiorenal syndrome(CRS). Methods One hundred and sixty six patients with type 3 CRS admitted in the nephrology department of Shanghai Tongji Hospital from January 2014 to December 2017 were retrospectively enrolled. The anthropometric, history, clinical, biochemical data were compared between the survival and fatal patients. The risk factors of 1-year mortality were analyzed with logistic regression analysis. Results One hundred and eighteen patients were survival and 48 died within one year with a 1-year mortality rate of 40.68%. There were significant differences in age[68(58,81) vs 81(73,85), P=0.001], systolic blood pressure(SBP) during hospitalization[146(130,173) vs 131(120,148) , P=0.002], rehospitalization[3(0,5) vs 1(0,3), P=0.016], serum C reactive protein(CRP)[12(3.75,34.25) vs 22(6,80.5), P=0.018] between survival and fatal groups. Logistic regression analysis showed that SBP during hospitalization（OR=0.973, P=0.025,）was an independent risk factor for the prediction of 1-year mortality in patients with type 3 CRS. Conclusion Type 3 CRS patients have high 1-year mortality, and systolic blood pressure during hospitalization may predict the mortality.