Scios资助的研究发现预测心功能衰竭死亡风险的新工具

一项新型实用工具已经被研制出来，用于预测心功能衰竭住院病人的高度、中等、以及低度死亡危险，而这只需要两次简单的血液检查和一次血压测定。

为了开发能够评估心功能衰竭患者死亡率的工具，研究人员使用一种CART(classification and regression tree，分类与回归树)统计分析一些临床变量。从超过65000心功能衰竭住院患者的39种临床变量的观察评估，研究人员明确了三种发现最大死亡可能的临床变量。分别是高水平血尿素氮（BUN大于或者等于mg/dl）、低收缩压(SBP > 115 mm HG)、高血肌酐(Cr大于或者等于2.75 mg/dl）。这种评估工具的可靠性使用另外32229例住院患者的资料进行了证实。

急性心功能衰竭患者的总死亡率是4.1％。新工具评测死亡危险的水平为低风险2.1％～高风险为21.9％。Clyde W. Yancy医生是德克萨斯州大学西南医学中心(Dallas, USA; www.swmed.edu)医学与心血管学教授，是这项试验的研究员。

“这种新工具是评估治疗急性失代偿心功能衰竭的第一种，为临床医生在患者入院的时候就提供了简便快速的风险评估，以能够快速确定治疗措施。”位于洛杉矶的加利福尼亚大学心血管科的医学教授Gregg C. Fonarow医生如此评论。

这项研究由世界最大的心功能衰竭登记处完称的，该组织叫做ADHERE(acute ecompensated heart failure)，得到了Scios集团(San Francisco, CA, USA)的资助。该研究结果发表在在2005年2月2日的《美国医学会期刊》。

Death Risk of Heart Failure Patients
 
A new practical tool has been developed to predict the high, intermediate, and low risk of death in hospitalized heart failure patients, using two simple blood tests and a single blood pressure measurement.

Investigators used a type of statistical analysis known as CART (classification and regression tree) to analyze a number of clinical variables in order to develop a tool to assess mortality risk in heart failure patients. From an observational evaluation of 39 clinical variables from more than 65,000 hospitalized heart failure patients, they were able to define three clinical characteristics that put patients at greatest risk of mortality. These are high levels of blood urea nitrogen (BUN greater or equal to mg/dl), low systolic blood pressure (SBP > 115 mm HG), and high serum creatinine (Cr greater than or equal to 2.75 mg/dl). The validity of this tool was tested using data from an additional 32,229 hospitalizations.

The overall mortality risk for patients hospitalized with acute heart failure was 4.1%. The new tool determined mortality risk levels starting from low risk at 2.1% up to 21.9% for patients with the highest risk.

Clyde W. Yancy, M.D., professor of medicine and cardiology at the University of Texas Southwestern Medical Center (Dallas, USA; www.swmed.edu) was a contributing investigator of the study.

“This new tool is a first for the treatment of acute decompensated heart failure, and offers a simple quick way for clinicians to assess mortality risk upon hospital admission and rapidly decide on a treatment strategy,” noted Gregg C. Fonarow, M.D., professor of medicine in the division of cardiology at the University of California, Los Angeles (USA).

The study was conducted by investigators from the world’s largest heart failure registry, known as ADHERE (acute decompensated heart failure), sponsored by Scios, Inc. (San Francisco, CA, USA). The study was published in the February 2, 2005, issue of the Journal of the American Medical Association.