| Abstract | Uvod: Zatajivanje srca je klinički sindrom uzrokovan različitim strukturnim ili funkcionalnim poremećajima srca. Vodeći je uzrok hospitalizacija osoba starijih od 70 godina. Svrha rada: Analizirati klinički profil, liječenje i ishod bolesnika s akutnom dekompenzacijom zatajivanja srca u dva različita vremenska razdoblja Ispitanici i metode: Istraživanje obuhvaća 1820 bolesnika u razdoblju od lipnja 2006. do lipnja 2012. godine i 511 bolesnika tijekom 2014. godine na Odjelu za kardiovaskularne bolesti Kliničkog bolničkog centra Rijeka. Rezultati: Tijekom 6 – godišnjeg razdoblja prosječna dob bolesnika bila je 75,1 ± 10,1 godina, 51% činile su žene. 68% bolesnika imalo je ranije liječenu arterijsku hipertenziju, 56% kroničnu bubrežnu bolest, 52% koronarnu bolest srca, 40% anemiju i 38% dijabetes melitus. Pri prijemu u 51% bolesnika dijagnosticira se fibrilacija atrija. Analiza NT – proBNP izvodila se u 36% bolesnika, dok se ehokardiografija prakticirala u njih 73% s prosječnom vrijednosti ejekcijske frakcije 39,3 ± 14,6%. 3,7 iznosila je prosječna vrijednost razreda NYHA klasifikacije. Farmakološka terapija uključivala je 98% diuretika, 82% β – blokatora, 77% ACE inhibitora ili ARB, 27% digitalisa, 25% antagonista aldosterona. Tijekom šestogodišnjeg razdoblja, 289 (16%) bolesnika umire tijekom hospitalizacije, a prosječna duljina boravka u bolnici svih bolesnika bila je 9,9 ± 17,9 dana. Usporedbom podataka preživjelih bolesnika u dva različita vremenska perioda ne postoji značajna razlika u prosječnoj dobi i spolu. Statistički značajna razlika je u duljini boravka u bolnici i u primjeni farmakološke terapije. Zaključak: Rezultati ovog istraživanja generalno su usporedivi s rezultatima drugih nacionalnih studija te pomažu evaluirati vlastiti rad i usmjeriti djelovanja našeg Centra prema preporukama ESC. |
| Abstract (english) | Introduction: Heart failure is a clinical syndrome caused by a variety of structural or functional heart disorders. It's the leading cause of hospitalizations of persons over 70.
Purpose: To analyze the clinical profile, treatment and outcome of patients with acutely decompensated heart failure in two different time periods.
Patients and Methods: The study includes 1820 patients from June 2006 to June 2012 and 511 patients during 2014 at the Department of Cardiovascular Diseases, Clinical Hospital Center Rijeka.
Results: During a six – year period, the average age of patients was 75,1 ± 10,1 years, 51% were women. 68% of patients had treated arterial hypertension, 56% chronic kidney disease, 52% coronary heart disease, 40% anaemia and 38% diabetes mellitus. At admission, 51% of patients had atrial fibrillation. Analysis of NT - proBNP is performed in 36% of patients, while echocardiography is practiced in 73% with average ejection fraction of 39,3 ± 14,6%.The mean NYHA class value was 3,7. Pharmacological therapy included 98% of diuretics, 82% of β - blockers, 77% of ACE inhibitors or ARBs, 27% of digoxin, 25% of aldosterone antagonists. During a six – year period, 289 (16%) patients die during the hospitalization and the average length of hospital stay of all patients was 9,9 ± 17,9 days. Comparison of the data of surviving patients in two different time periods showed that there is no significant difference in the average age and gender. A statistically significant difference is in the length of hospital stay and in the use of medications.
Conclusion: The results of this study are generally comparable with the results of other national studies. They help us to evaluate our work and direct activities of our Centre according to recommendation of ESC. |
