A Nested Case-control Study Of Endpoint Events For 1578 Patients With Chronic Heart Failure In Traditional Chinese Medicine Hospitals

ObjectiveTo observe the occurrence of endpoint events during hospitalization and follow-up in 1578 patients with chronic heart failure in traditional Chinese medicine hospitals,explore the factors influencing the occurrence of endpoint events in patients with chronic heart failure,and provide evidence-based medical evidence for the prevention and treatment of chronic heart failure.MethodA nested case-control study was conducted.Relying on the medical record management system of the medical record rooms of shandong hospital of traditional Chinese medicine,weifang hospital of traditional Chinese medicine and rizhao hospital of traditional Chinese medicine,1578 patients with chronic heart failure who met the inclusion criteria were admitted on January 1,2012 and December 31,2017 as the cohort.The basic information,indicators,application of traditional Chinese medicine and the occurrence of terminal events of the patients in the cohort during hospitalization were sorted out and summarized.Epidate software was used to establish a database and input data.Patients with cardiac death during hospitalization in the cohort were the case group,with a total of 15 cases.According to the principle of hospital,same gender and age difference(±2 years),4 patients without cardiac death were matched as the control group for each patient with chronic heart failure in the cohort,and a total of 60 cases were in the control group.40 cases of end-point events occurred during hospitalization were removed,and 1538 cases of chronic heart failure were followed up later,a total of 1400 cases were successfully followed up.A total of 185 patients with cardiac death during follow-up were selected as the case group.According to the principle of hospital,same gender and age difference(±2 years),2 patients without cardiac death were matched as the control group for each patient with chronic heart failure who had cardiac death in the cohort.The control group had 370 cases in total.Patients with heart failure readmission during follow-up were selected as the case group,with a total of 349 cases.According to the principle of the same hospital,the same gender,and the difference in age(±2 years),each patient with chronic heart failure readmission in the cohort was matched with one patient without heart failure readmission as the control group,with a total of 349 cases in the control group.Univariate analysis during hospitalization was performed by chi-square test,multivariate analysis was performed by Logistic regression model,univariate analysis was performed by kaplan-meier analysis during follow-up,and multivariate analysis was performed by Cox model to analyze the factors influencing the occurrence of end-point events in patients with chronic heart failure during hospitalization and follow-up.Result1.During hospitalizationNYHA classification(OR=0.136,95%CI=0.039-0.139)was factors associated with cardiac death during hospitalization of chronic heart failure.2.Follow-up period(1)Exposure(OR=0.650,95%CI=0.476-0.889),NYHA classification(OR=1.917,95%CI=1.529-2.405),Atrial fibrillation(OR=1.365,95%CI=1.018-1.718)were the source of heart during chronic heart failure follow-up Factors related to sexual death.(2)Exposure(OR=1.673,95%CI=1.333-2.098),NYHA classification(OR=1.218,95%CI=1.036-1.433),and atrial fibrillation(OR=0.789,95%CI=0.636-0.979)were during chronic heart failure follow-up Relevant factors for heart failure readmission.Conclusion1.During hospitalizationNYHA classification was related factor associated with cardiac death during hospitalization of chronic heart failure.2.Follow-up period(1)TCM therapy,NYHA classification,and atrial fibrillation were related factors of cardiac death during follow-up.(2)TCM therapy,NYHA classification,and atrial fibrillation were related factors for heart failure readmission during follow-up.