著者
Naofumi Yoshida Sachiyo Iwata Masato Ogawa Kazuhiro P. Izawa Shunsuke Kuroda Shun Kohsaka Taishi Yonetsu Takeshi Kitai Sho Torii Takahide Sano Yoshitada Sakai Tomoya Yamashita Ken-ichi Hirata Yuya Matsue Shingo Matsumoto Koichi Node
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.3, no.7, pp.375-380, 2021-07-09 (Released:2021-07-09)
参考文献数
18
被引用文献数
4

Background:The COVID-19 pandemic has challenged healthcare systems, at times overwhelming intensive care units (ICUs). We aimed to describe the length and rate of ICU admission, and explore the clinical variables influencing ICU use, for COVID-19 patients with known cardiovascular diseases or their risk factors (CVDRF).Methods and Results:A post hoc analysis was performed of 693 Japanese COVID-19 patients with CVDRF enrolled in the nationwide CLAVIS-COVID registration system between January and May 2020 (mean [±SD] age 68.3±14.9 years; 35% female); 199 patients (28.7%) required ICU management. The mean (±SD) ICU length of stay (LOS) was 19.3±18.5 days, and the rate of in-hospital death and hospital LOS were significantly higher (P<0.001) and longer (P<0.001), respectively, in the ICU than non-ICU group. Logistic regression analysis revealed that clinical variables reflecting impaired general condition (e.g., high C-reactive protein, low Glasgow Coma Scale score, SpO2, albumin level), male sex, and previous use of β-blockers) were associated with ICU admission (all P<0.001). Notably, age was inversely associated with ICU admission, and this was particularly prominent among elderly patients (OR 0.97, 95% confidence interval 0.95–0.99; P=0.0018).Conclusions:One-third of COVID patients with CVDRF required ICU care during the first phase of the pandemic in Japan. Other than anticipated clinical variables, such as hypoxia and altered mental status, age was inversely associated with the use of the ICU, warranting further investigation.
著者
Naoki Tamada Kazuhiko Nakayama Kenichi Yanaka Hiroyuki Onishi Yuto Shinkura Yu Taniguchi Hiroto Kinutani Yasunori Tsuboi Kazuhiro P. Izawa Seimi Satomi-Kobayashi Hiromasa Otake Hiroshi Tanaka Toshiro Shinke Yutaka Okita Noriaki Emoto Ken-ichi Hirata
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.1, no.5, pp.228-234, 2019-05-10 (Released:2019-05-10)
参考文献数
27
被引用文献数
2

Background:While hemodynamics and exercise capacity in patients with chronic thromboembolic pulmonary hypertension (CTEPH) can be improved by invasive therapy such as pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA), there has been little data on the health-related quality of life (HRQOL) in such patients.Methods and Results:This single-center and observational study compared the impact of invasive therapy on HRQOL. We utilized the Medical Outcome Study 36-Item Short Health Survey (SF-36) to measure HRQOL and compared HRQOL changes after PEA and BPA. A total of 48 patients were diagnosed with CTEPH. Of these, 39 patients completed questionnaires before and after invasive therapy. The PEA group (n=15) and the BPA group (n=24) had similar improvements in clinical parameters. With regard to HRQOL score, both groups had fairly low scores in physical functioning (PF), role physical (RP), general health (GH), social functioning (SF), role emotional (RE), and physical component summary (PCS) at baseline. PF, GH, vitality (VT), mental health (MH), and PCS had significant improvements in the PEA group while PCS and all subscales except for bodily pain (BP) had significant improvements in the BPA group. Furthermore, changes between baseline and follow-up were not significantly different between the 2 groups.Conclusions:BPA for patients who are ineligible for PEA can recover HRQOL to a similar level to that achieved by PEA.