心不全患者における再入院および死亡リスクの高さを明らかに(High risk of readmission and death among heart failure patients)

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2026-02-25 カロリンスカ研究所(KI)

スウェーデンのカロリンスカ研究所の研究によると、心不全患者は退院後早期に再入院や死亡のリスクが高いことが明らかになった。大規模な患者データを解析した結果、特に退院直後の数週間が最も危険な期間であり、併存疾患や高齢がリスク増大に関連していた。研究者は、退院後の継続的フォローや個別化された治療計画の強化が予後改善に重要だと指摘。医療体制の見直しにより、再入院の減少と生存率向上が期待されるとしている。

<関連情報>

駆出率低下、軽度低下、または維持された駆出率を伴う心不全の転帰:ESC HF IIIレジストリ Outcomes of heart failure with reduced, mildly reduced, or preserved ejection fraction: the ESC HF III registry

Lars H Lund,Aldo P Maggioni,Maria G Crespo-Leiro,Cecile Laroche,Israel Gotsman,Belma Pojskic,Eleonora B Vataman,Lucica Grigorica,Hamayak Sisakian,Duska Glavas,…
European Heart Journal  Published:25 February 2026
DOI:https://doi.org/10.1093/eurheartj/ehaf1074

心不全患者における再入院および死亡リスクの高さを明らかに(High risk of readmission and death among heart failure patients)
Structured Graphical abstract

Abstract

Background and Aims

To assess in-hospital and 1-year cause-specific outcomes in the contemporary European Society of Cardiology (ESC) Heart Failure (HF) III Registry.

Methods

Patients were enrolled in European or ESC affiliated countries and characterized in detail regarding clinical characteristics and cause-specific outcomes.

Results

Between 1 November 2018 and 31 December 2020, 10,162 patients were enrolled from 220 centres in 41 countries. Of these, 39% had acute HF (‘AHF’, age 70 [62–79] years, 36% women) and 61% had out-patient visit for HF [‘out-patient HF’, age 66 (58–75) years, 33% women]. Overall, 58% had HF with reduced ejection fraction (HFrEF), 17% HF with mildly reduced ejection fraction (HFmrEF), and 25% HF with preserved ejection fraction (HFpEF). In AHF, median [interquartile range (IQR)] duration of hospitalization was 9 (6–14) days, and 5.1% died in hospital (HFrEF 5.2%; HFmrEF 4.8%, HFpEF 3.4%). In AHF discharged alive and in out-patient HF, after a median (IQR) follow-up of 376 (360–432) days, all-cause, cardiovascular (CV), and unknown-cause mortality rates per 100 patient-years were as follows: AHF HFrEF: 19, 13, and 3.0 per 100 patient-years. The corresponding numbers were in AHF HFmrEF: 22, 11, and 6.3; AHF HFpEF: 16, 7.0, and 4.7; out-patient HFrEF: 6.6, 4.3, and 0.9; out-patient HFmrEF: 4.0, 2.6, and 0.8; out-patient HFpEF: 3.9, 1.7, and 1.2. At least one (re-)hospitalization for HF was experienced in 44% AHF HFrEF, 42% AHF HFmrEF, 36% AHF HFpEF, 21% out-patient HFrEF, 14% out-patient HFmrEF, and 18% out-patient HFpEF.

Conclusions

In HF in Europe and affiliated countries, in-hospital mortality was 5.1% and greater with lower ejection fraction. Among hospital survivors and out-patients over 1 year of follow-up, event rates per 100 patient-years varied for death, 3.9–22, CV death 1.7–13, and unknown cause of death 0.8–6.3. The percent of patients that were (re-)hospitalized for HF at least once over 1-year follow-up ranged 14–44% and was twice as high post-AHF compared with post-out-patient visit.

医療・健康
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