Journal of Shanghai Jiao Tong University (Medical Science) ›› 2022, Vol. 42 ›› Issue (6): 778-785.doi: 10.3969/j.issn.1674-8115.2022.06.012

• Clinical research • Previous Articles    

Clinical characteristics and health economics evaluation of real-world-based ischemic cardiovascular and cerebrovascular co-morbidities

Xieyire·HAMULATI 1(), ZHAO Qian1, LI Cheng1, SONG Ning1, WANG Ying1, Gulijiehere·TUERXUN 1, PU Jun2, YANG Yining1,3, LI Xiaomei1()   

  1. 1.Heart Center of the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
    2.Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    3.Department of Cardiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
  • Received:2022-02-10 Accepted:2022-04-28 Online:2022-06-28 Published:2022-08-19
  • Contact: LI Xiaomei E-mail:905368281@qq.com;lixm505@163.com
  • Supported by:
    National Key Research and Development Program of China(2018YFC1312804)

Abstract: Objective

·To investigate the clinical characteristics of ischemic cardiovascular and cerebrovascular co-morbidities and the actual factors influencing the extension of hospitalization days.

Methods

·Patients with first diagnosis of coronary artery heart disease (CHD) or cerebrovascular disease in the First Affiliated Hospital of Xinjiang Medical University from December 2009 to June 2020 were selected as participants by retrieving electronic medical record (EMR) and divided into CHD group, cerebrovascular disease group, and cardiovascular and cerebrovascular co-morbidities group. Retrospective analysis was performed to compare the characteristics, hospitalization days and costs of each group, and compare the correlation between different costs and total hospitalization costs in each group. Logistic regression analysis was used to explore the influencing factors associated with hospitalization days extension.

Results

·A total of 22 216 patients were selected. Compared with single-disease groups, the patients in the comorbid group were older [(67±9) years] and had a higher prevalence of hypertension and atrial fibrillation, 75.4% and 9.0%, respectively; low-density lipoprotein cholesterol (LDL-Ch), leukocyte, and hemoglobin (Hb) levels were the highest (all P< 0.05). CHD group had a higher proportion of males (65.8%, P=0.000), 37.2% and 23.5% of patients with smoking and drinking habits,and high prevalence of diabetes and dyslipidemia, 43.8% and 64.0%, respectively (all P<0.05). In terms of hospitalization costs, the total hospital costs had a stronger correlation with consumables costs in the cardiovascular and cerebrovascular co-morbidity group (P=0.000). The occurrence of co-morbidities led to increased costs for supplies and out-of-pocket expenses. Multifactorial Logistic regression analysis showed that gender (OR=1.158,95%CI 1.004?1.336, P=0.045), age (OR=1.317,95%CI 1.112?1.559, P=0.000) and prevalence of dyslipidemia (OR=1.361, 95%CI 1.167?1.586, P=0.000) all correlated with longer hospitalization days (all P<0.05). Elevated blood pressure, higher low-density lipoprotein, and atrial fibrillation prevalence increased the number of hospital days in the cardiovascular and cerebrovascular co-morbidities group.

Conclusion

·Patients with cardiovascular and cerebrovascular co-morbidities are characterized by older age, high prevalence of hypertension and atrial fibrillation, as well as higher LDL-Ch, WBC, and Hb levels. The male age, and prevalence of dyslipidemia are the main risk factors that mainly influence the extension of hospitalization days in patients with cardiovascular and cerebrovascular co-morbidities.

Key words: cardiovascular disease, cerebrovascular disease, health economic evaluation, clinical characteristic, real-world study

CLC Number: