一項(xiàng)新型實(shí)用工具已經(jīng)被研制出來，用于預(yù)測(cè)心功能衰竭住院病人的高度、中等、以及低度死亡危險(xiǎn)，而這只需要兩次簡(jiǎn)單的血液檢查和一次血壓測(cè)定。

為了開發(fā)能夠評(píng)估心功能衰竭患者死亡率的工具，研究人員使用一種CART(classification and regression tree，分類與回歸樹)統(tǒng)計(jì)分析一些臨床變量。從超過65000心功能衰竭住院患者的39種臨床變量的觀察評(píng)估，研究人員明確了三種發(fā)現(xiàn)最大死亡可能的臨床變量。分別是高水平血尿素氮（BUN大于或者等于mg/dl）、低收縮壓(SBP > 115 mm HG)、高血肌酐(Cr大于或者等于2.75 mg/dl）。這種評(píng)估工具的可靠性使用另外32229例住院患者的資料進(jìn)行了證實(shí)。

急性心功能衰竭患者的總死亡率是4.1％。新工具評(píng)測(cè)死亡危險(xiǎn)的水平為低風(fēng)險(xiǎn)2.1％～高風(fēng)險(xiǎn)為21.9％。Clyde W. Yancy醫(yī)生是德克薩斯州大學(xué)西南醫(yī)學(xué)中心(Dallas, USA; www.swmed.edu)醫(yī)學(xué)與心血管學(xué)教授，是這項(xiàng)試驗(yàn)的研究員。

“這種新工具是評(píng)估治療急性失代償心功能衰竭的第一種，為臨床醫(yī)生在患者入院的時(shí)候就提供了簡(jiǎn)便快速的風(fēng)險(xiǎn)評(píng)估，以能夠快速確定治療措施。”位于洛杉磯的加利福尼亞大學(xué)心血管科的醫(yī)學(xué)教授Gregg C. Fonarow醫(yī)生如此評(píng)論。

這項(xiàng)研究由世界最大的心功能衰竭登記處完稱的，該組織叫做ADHERE(acute ecompensated heart failure)，得到了Scios集團(tuán)(San Francisco, CA, USA)的資助。該研究結(jié)果發(fā)表在在2005年2月2日的《美國(guó)醫(yī)學(xué)會(huì)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.