Correlation of treatment regimen with middle- and long-term rehospitalization in senile patients with coronary heart diseases in Chongqing region of China
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    Abstract:

    Objective To investigate the correlation of different options of treatment regimens with 1- and 3-year rehospitalization rate in the patients aged over 70 years with coronary heart diseases (CHD) diagnosed by coronary angiography. Methods A retrospective cohort study was carried out on the clinical data and follow-up phone calls in the inpatients over 70 years old hospitalized in our department from January 2008 to October 2011. The 211 enrolled patients were divided into four groups according to their vasculopathy and surgical approach. In group A(n=38), the patients refused interventional therapy, with ≥70% stenosis in coronary artery. In group B(n=40), the patients received percutaneous coronary angioplasty and stent implantation, with ≥50% stenosis in coronary artery. In group C(n=106), the patients received percutaneous coronary angioplasty and stent implantation, without ≥50% stenosis in coronary artery. In group D(n=27), the patients had no necessity for percutaneous coronary intervention though with 50% to 70% stenosis in coronary artery. In these four groups, patients hospitalized during January 2008 to October 2009 were subjected into four subgroups respectively, as group A1(n=24), B1(n=18), C1(n=50) and D1(n=16). Numbers of patients who rehospitalized due to heart event in the followed 1 or 3 years were noted and compared. Results There were 211 (108) patients enrolled into the four groups (subgroups). There was no significant difference in their age, gender, complicated with diabetes and hypertension, smoking, and serum levels of creatinine, cholesterol, hemoglobin and B-type natriuretic peptide (BNP) between the four groups (subgroups) at baseline (P>0.05). The rehospitalization rate in followed one year was 28.9% (29.2%), 20.0% (22.2%), 6.6% (6.0%) and 7.4% (6.3%) respectively for the four groups (subgroups) respectively, with that of group A statistically different to total rate (13.3%, P=0.026). The rehospitalization rate in followed 3 years was 41.6%, 27.8%, 10.0% and 25.0% respectively for the four subgroups, with those of subgroup A1 and C1 statistically different to the total rate (22.2%, P=0.047,P=0.048). Multivariate regression analysis indicated that diabetes and treatment regimens were risk factors for rehospitalization due to heart event. Conclusion The results suggest that, for the patients over 70 years old with coronary heart diseases, receiving percutaneous coronary angioplasty and stent implantation is recommended to avoid rehospitalization. While, for those with 50% to 70% stenosis but with no need for interventional therapy, medical education should be carried out for them to improve their drug compliance.

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  • Online: July 01,2013
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