Volume 42 Issue 6
Jul.  2021
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Bin LIU, Xian-gang LI, Min ZHANG, Fang ZHOU, Ren-hua LIN, Jie YANG, Liang ZHANG, Xian-kun WANG, Ya-nan PAN. Main Influencing Factors of the Second Hospitalization of Patients with Coronary Heart Disease[J]. Journal of Kunming Medical University, 2021, 42(6): 103-109. doi: 10.12259/j.issn.2095-610X.S20210618
Citation: Bin LIU, Xian-gang LI, Min ZHANG, Fang ZHOU, Ren-hua LIN, Jie YANG, Liang ZHANG, Xian-kun WANG, Ya-nan PAN. Main Influencing Factors of the Second Hospitalization of Patients with Coronary Heart Disease[J]. Journal of Kunming Medical University, 2021, 42(6): 103-109. doi: 10.12259/j.issn.2095-610X.S20210618

Main Influencing Factors of the Second Hospitalization of Patients with Coronary Heart Disease

doi: 10.12259/j.issn.2095-610X.S20210618
  • Received Date: 2021-02-08
  • Publish Date: 2021-06-25
  •   Objective   To evaluate the causes and influencing factors of re-hospitalization of patients with coronary heart disease by coronary angiography, so as to guide clinical diagnosis and treatment decisions and reduce re-hospitalization.   Methods   From January 2013 to December 2019, a total of 316 patients who were hospitalized twice with coronary angiography and/or percutaneous coronary intervention were analyzed retrospectively, including 235 males and 81 females, with a male to female ratio of 2.9∶1. According to the times of hospitalization, they were divided into the first hospitalization group and the second hospitalization group, with an average age of 59.45 ±10.09 years and 60.47±10.16 years. The average time interval between the two hospitalizations was 14.30±11.67 months. Among them, 265 patients were diagnosed with coronary heart disease for the first time and percutaneous coronary intervention (PCI), accounting for 83%.   Results   After two hospitalizations, there were significant differences in LDL-C, TG, diabetes history smoking history, drinking history, first-time clinical diagnosis, severity of lesion (Gensini score) of each blood vessel (LAD, RCA, LCX), and stent placement of each blood vessel between the two groups (P < 0.05). The number of diabetic patients increased during the second hospitalization, with significant difference ( P < 0.05) Multivariate Logistic regression analysis showed that LDL-C control was not up to standard, and the low rate of reaching the standard (13.3%, 31.0%) was an independent risk factor affecting the second hospitalization of patients with coronary heart disease (OR = 1.985, 95%CI 1.506~2.617). RCA, LAD and LCX were the protective factors for the second hospitalization of patients with coronary heart disease [(OR = 0.304, 95%CI 0.144~0.642), (OR = 0.184, 95%CI 0.099~0.343), (OR = 0.228, 95%CI 0.123~0.424)] Compared with those who were diagnosed as ST-segment elevation myocardial infarction (STEMI) for the first time, active revascularization treatment was a protective factor for re-hospitalization of patients who were diagnosed as stable angina pectoris (SAP), unstable angina pectoris (UAP) and non-ST-segment elevation myocardial infarction (NSTEMI) again [(OR = 0.071, 95%CI 0.031~0.163), OR = 0.323, 95%CI 0.117~0.743, P < 0.05]. However, there was no significant difference in age, TC, HDL-C, Cre, BUN, UA, FPG, hypertension and vascular diseases of various coronary arteries ( P > 0.05).   Conclusion   Strict control of LDL-C level in patients with coronary heart disease can effectively prevent and control the progress of diabetes, and actively carry out effective revascularization on seriously diseased coronary vessels during the first hospitalization can reduce the occurrence of second hospitalization.
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