| Objective: 1.To investigate the clinical characteristics of elderly patients with CHF and Af.2.Objective to explore the influencing factors of drug compliance in elderly patients with CHF and Af after discharge.3.Objective to explore the predictive factors of all-cause death in elderly patients with CHF and Af after discharge.Methods: From January 2019 to March 2020,the elderly patients with CHF complicated with Af who received regular treatment and successfully discharged from the First Affiliated Hospital of Shihezi University were selected.The general information,test indexes,examination indexes,discharge diagnosis and medication status were collected.The patients were followed up by telephone or outpatient at 2 months and 1 year after discharge data of medication situation and medication compliance,and whether the endpoint event occurred at 1 year.The possible influencing factors of medication compliance were included,and the significant factors of univariate logistic regression analysis were included in multivariate logistic regression analysis.The influencing factors of medication compliance of elderly patients with CHF and Af after discharge were obtained.Kaplan Meier survival curve was drawn to analyze all-cause death one year after discharge.Cox risk regression model was used to analyze the predictive factors of all-cause death.The difference was statistically significant(P < 0.05).Results: 1.A total of 233 elderly patients with CHF and Af were included in this study,with an average age of 76.33 years ± 83 years old,male 123 cases(52.8%),female 110 cases(47.2%);Among them,160cases(68.7%)had coronary heart disease,140 cases(60.1%)had hypertension,followed by 51 cases(21.9%)with diabetes mellitus and 48 cases(20.6%)with chronic kidney injury;The main severity of heart failure was cardiac function III(51.5%),followed by cardiac function IV(25.3%)and cardiac function II(23.2%);5-8 kinds of drugs accounted for the majority(73.4%),9-12 kinds(13.3%),less than 4kinds(12.4%)and more than 12 kinds(0.9%);There were 203 patients(87.1%)with medical insurance and 30 patients(12.9%)without medical insurance;209 cases(89.7%)lived alone,24 cases(10.3%)lived alone.2.2 months after discharge,62.0% of the patients had good medication compliance and 38.0% had poor medication compliance;By comparing the clinical data of patients with good medication compliance and poor medication compliance,it was found that the patients with poor medication compliance were often elderly,male,more comorbidity,high serum creatinine,living alone,oral anticoagulants(P < 0.05);Multivariate logistic regression analysis showed that there were significant differences in gender(OR =3.225,95% CI = 1.734-5.998,P < 0.001),age(OR = 0.953,95% CI = 0.915-0.992,P = 0.019),living alone(OR = 3.579,95% CI = 1.262-10.150,P = 0.016)and oral anticoagulants(OR = 0.357,95% CI =0.168-0.760,P = 0.008)between the two groups(P < 0.05).3.233 patients were followed up for one year,17.2% of them died from all causes.Compared with the patients with positive end point,there were statistically significant differences in NYHA cardiac function grade,Barthel index score,D-dimer,albumin,LVEF value,serum creatinine,total number of comorbidities,medication compliance and course of CHF(P < 0.05);Multivariate Cox regression analysis showed that high NYHA cardiac function grade,long course of CHF and poor medication compliance were the risk factors for one-year all-cause death in elderly patients with CHF and Af.Conclusion: The elderly patients with CHF and Af in this study are mainly older,more basic diseases and poor cardiac function;Old age,male,living alone and the use of anticoagulants may be the causes of poor medication compliance in elderly patients with CHF and Af;Patients with poor cardiac function,long course of CHF and poor medication compliance may have a higher risk of all-cause death within one year. |
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