摘要
Abstract
Objective To explore the influence of mean arterial pressure(MAP)on 6-month readmission and mortality in elderly patients with heart failure.Methods A retrospective study was conducted on the clinical data of 1,826 patients from the heart failure database of Zigong city from December 2016 to June 2019.PostgreSQL 9.6 software was used to extract the data from the MIM-IC-Ⅳ database.The patients were divided into four groups according to MAP levels,and three different models,including the crude model,were established.Statistical analyses were performed on the models.Model 2(adjusted for gender and age)and Model 3(ad-justed for all potential factors)were used to establish generalized linear models and generate smoothed fitting curves for MAP in relation to 6-month readmission and mortality.Cox proportional hazards regression models were employed to compare the impact of different MAP levels on 6-month readmission and mortality.Restricted cubic spline regression models were used to explore the response relation-ship between MAP and 6-month readmission and mortality,and comparisons were made through log-rank tests.Results A total of 1,826 patients were included in this study,including 743 males and 1,083 females.The analysis revealed a non-linear association be-tween MAP and the risks of mortality and readmission in the patients with heart failure.Particularly in elderly patients with heart fail-ure,MAP levels demonstrated a significant correlation with the 6-month readmission and mortality.After multivariable adjustment,no statistically significant differences were observed in the 6-month readmission or mortality between the patients with MAP below 83.33 mmHg and those with MAP in the range of 83.33 to 94 mmHg.However,the patients with MAP values between 94 and 105.33 mmHg exhibited a 30%lower risk of readmission and a 28%lower risk of mortality compared to those with lower MAP levels,respectively.Higher average MAP levels were significantly linked to a lower risk of 6-month readmission,as well as the composite endpoint encompassing the 6-month readmission and mortality.After adjusting for multiple variables,this association persisted,indicating that MAP levels might serve as a significant independent prognostic factor in the elderly population.Specifically,the risks increased when MAP levels were below 83.33 mmHg or above 105.33 mmHg,the risk increased.Conclusions MAP is associated with the risks of 6-month mortality and readmission among patients with heart failure,showing a J-shaped curve relationship.关键词
平均动脉压/心力衰竭/再入院/全因死亡率/队列研究Key words
mean arterial pressure/heart failure/readmission/all-cause mortality/cohort study分类
医药卫生
