不良生活方式聚集对慢性心力衰竭患者1年内再住院风险的叠加效应分析

doi:10.12183/j.scjpm.2026.0785

摘要/Abstract

摘要： 目的分析不良生活方式聚集对慢性心力衰竭（CHF）患者1年内再住院风险的叠加效应。方法前瞻性选取2023年5月至2024年4月临泉县人民医院心内科住院CHF患者,出院前收集不良生活方式（膳食、运动、睡眠、情绪、吸烟饮酒5个维度）,构建不良生活方式聚集指数（ULSI）,分为低（0~1项）、中（2~3项）、高（4~5项）聚集组。随访1年记录再住院情况,采用χ²检验、logistic回归及趋势检验分析ULSI与再住院风险的关系。结果共纳入355例患者（失访13例）,1年内再住院63例（17.75%）。低、中、高聚集组再住院率分别为9.59%（7/73）、15.15%（30/198）和30.95%（26/84）,差异有统计学意义（χ²=14.277,P=0.001）。多因素logistic回归分析结果显示,调整NYHA心功能分级和服药依从性后,高聚集组再住院风险显著高于低聚集组（OR=2.744,95% CI：1.025~7.346,P=0.045）,中聚集组差异无统计学意义（OR=1.087,95% CI：0.426~2.771,P=0.862）。趋势检验显示ULSI每增加1个等级,再住院风险升高81.5%（OR=1.815,95% CI：1.130~2.918,P=0.014）。结论不良生活方式聚集对CHF患者1年内再住院风险存在独立叠加效应,聚集程度越高,再住院风险越大,临床应重视多维度生活方式评估与综合干预。

关键词: 慢性心力衰竭, 再住院, 不良生活方式聚集, 叠加效应

Abstract: Objective To evaluate the cumulative effect of clustered unhealthy lifestyle factors on the risk of readmission for patients with chronic heart failure (CHF) within one year. Methods A prospective cohort was established consisting of 355 CHF patients admitted to the Department of Cardiology at Linquan County People's Hospital between May 2023 and April 2024. Unhealthy lifestyle factors were categorized into five dimensions: diet, physical activity, sleep, emotional status, and smoking/alcohol consumption. Based on these dimensions, a Unhealthy Lifestyle Syndrome Index (ULSI) was constructed, dividing patients into three groups according to the number of unhealthy behaviors: Low (0-1 item), moderate (2-3 items), and high (4-5 items). Patients were followed up for one year to record readmission events. The relationship between ULSI and readmission risk was analyzed using χ² tests, logistic regression, and trend analysis. Results A total of 355 patients were enrolled (13 lost to follow-up), and 63 (17.75%) were rehospitalized within 1 year. The readmission rates among the low, moderate, and high ULSI groups were 9.59% (7/73), 15.15% (30/198), and 30.95% (26/84), respectively, with statistically significant differences (χ²=14.277, P=0.001). Multivariate logistic regression analysis revealed that, after controlling for New York Heart Association (NYHA) functional class and medication adherence, patients in the high ULSI group had a significantly increased risk of readmission compared to those in the low group (OR=2.744, 95% CI: 1.025-7.346, P=0.045), while no significant difference was observed between the moderate group and the low group (OR=1.087, 95% CI: 0.426-2.771, P=0.862). Trend analysis further indicated that each increment in ULSI level was associated with an 81.5% increase in readmission risk(OR=1.815, 95% CI: 1.130-2.918, P=0.014). Conclusion The clustering of unhealthy lifestyle factors independently contributes to the risk of readmission in CHF patients within one year, with higher clustering levels corresponding to greater readmission risks. Multi-dimensional lifestyle assessment and comprehensive intervention should be emphasized in clinical practice.

Key words: Chronic heart failure, Readmission, Clustered unhealthy lifestyle, Cumulative effect

中图分类号:

R193

李梓熠, 李静, 于玲. 不良生活方式聚集对慢性心力衰竭患者1年内再住院风险的叠加效应分析[J]. 华南预防医学, 2026, 52(7): 785-790.

Li Ziyi, Li Jing, Yu Ling. Cumulative effect of unhealthy lifestyle clustering on 1-year readmission risk in patients with chronic heart failure[J]. South China Journal of Preventive Medicine, 2026, 52(7): 785-790.

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