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Clinical Investigation of Hospital Death Cases with Chronic Heart Failure

Author: DingXu
Tutor: LinHaiLong
School: Dalian Medical University
Course: Department of Cardiology
Keywords: Chronic Heart failure Mode of death Therapy
CLC: R541.6
Type: Master's thesis
Year: 2010
Downloads: 47
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Abstract


Objective:We researched physical patients hospitalized in cardiovascular department in the past 8 years, and analyzed their clinical characteristics, mode of death and pharmacological therapy. The intention is to provide more information on the prevention and treatment strategy of chronic heart failure(CHF).methods:There were a total of 239 hospitalized death cases in cardiovascular department whose first diagnoses was chronic heart failure from January of 2002 to December of 2009, patients fulfilled the clinical diagnosis of chronic heart failure in 2007 the new guideline of chronic heart failure in diagnose and therapy. We analyzed their clinical characteristics, mode of death and pharmacological therapy and comparison with retrospective method.Results:(1) 239 death cases were analyzed with chronic heart failure as first diagnoses. The proportion of males was 53.5%. The average age were 74±16.3years. The survival time was51.3±40.3months,54.8% of these patients died between 1 to 5 years, after the diagnose of heart failure was conformed. (2) The two major causes of CHF were Coronary Heart Disease (CHD) and hypertension, with 46.4% and 21.3% respectively. The proportion of rheumatic heart disease (RHD) decreased significantly (13.4%) and CHD increased significantly (46.4%). This increase was due to the CHF after acute myocardial infarction(AMI) (22.2%).(3)The comparison included pneumonia, hyponatremia, renal insufficiency,the proportion was 64.90%,24.7% and 31%,respectively.(4) In terms of pharmacological treatment during hospital, diuretics, digitalis and nitride dominated were most regularly used, with the total proportion of 92.1% 81.6% and 85.0%; the use of ACEI,β-blocker, aldosterone blocker and aspirin was 73.8%、72.4%、90.8%、and 45.6%,respectively.(5) The mode of death were 144 in pump heart failure (60.37%),36 in sudden cardiac death (15.9%).8 in Cerebral infarction (3.3%),2 in Cerebral Hemorrhage (0.8%),44 in other complication(18.4%); 3 in dysnomia (1.3%)Conclusions:CHD and hypertension were the two major causes of CHF which cases died of; Pump failure and sudden cardiac death were the major mode of death with CHF.The pharmacological treatment used in the 239 patients we studied in this retrospective cohort study obey the treatment strategy of cardiovascular disease. the new guideline has been used in clinical practice, but improvement was still required.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Blood circulation failure
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