背景与目的心力衰竭(HF)的患病率呈上升趋势,它影响了美国（US）约500万人，患病率预计将从2012年的2.42％上升到2030年的2.97％。HF是导致住院和再入院的主要原因,这是美国医疗保健系统的主要经济负担。肥胖是广泛接受的HF的危险因素;然而,关于其与HF死亡率和发病率的独立关联的数据是异质的.全球范围内,超过三分之二的高体重指数(BMI)导致的死亡是由于心血管疾病(CVD).本研究旨在探讨肥胖（BMI>30Kg/m2）在心力衰竭患者30天再入院中的潜在作用。住院死亡率，以及使用无创正压通气（NIPPV）。方法在这个单中心，回顾性研究,纳入2015年1月至2018年1月在阿宾顿杰斐逊医院因主要诊断为HF而住院的所有成人(年龄:>18岁)患者.从电子病历中手动收集人口统计学特征。结果是30天的再入院由于HF，全因住院死亡率，和NIPPV的要求。采用多变量logistic回归分析研究肥胖与HF预后的关系。结果初步研究共1000例患者,根据纳入标准,这800例患者被纳入最终分析.与非肥胖患者相比，肥胖患者30天再入院和使用NIPPV的几率更高。肥胖与肥胖患者的住院死亡率没有显着差异。非肥胖患者。结论根据我们的发现，BMI>30Kg/m2是HF再入院的独立危险因素。此外,我们的结果强调了指南指导的药物治疗（GDMT）对HF加重的重要性，在肥胖患者中使用NIPPV的门槛较低，促进生活方式的改变，包括减肥，和出院后早期随访，以防止肥胖人群的HF再入院。
Background and objective The prevalence of heart failure (HF) is on the rise; currently, it affects around five million people in the United States (US) and the prevalence is expected to rise from 2.42% in 2012 to 2.97% in 2030. HF is a leading cause of hospitalizations and readmissions, accounting for a major economic burden to the US healthcare system. Obesity is a widely accepted risk factor of HF; however, data regarding its independent association with HF mortality and morbidity is heterogeneous. Globally, more than two-thirds of deaths attributable to high body mass index (BMI) are due to cardiovascular diseases (CVD). This
study aimed to investigate the potential role of obesity (BMI >30 Kg/m2) in HF patients in terms of 30-day readmissions, in-hospital mortality, and the use of noninvasive positive pressure ventilation (NIPPV). Methods In this single-center, retrospective
study, all adult (age: >18 years) patients who were hospitalized with a primary diagnosis of HF at the Abington Jefferson Hospital from January 2015 to January 2018 were included. Demographic characteristics were collected manually from electronic medical records. Outcomes were 30-day readmission due to HF, all-cause in-hospital mortality, and requirement for NIPPV. Multivariable logistic regression analysis was conducted to investigate the association of obesity with HF outcomes. Results A total of 1,000 patients were initially studied, of these 800 patients were included in the final analysis based on the inclusion criteria. Obese patients showed higher odds for 30-day readmissions and the use of NIPPV compared to non-obese patients. There was no significant difference in in-hospital mortality in obese vs. non-obese patients. Conclusions Based on our findings, BMI >30 Kg/m2 is an independent risk factor for HF readmissions. Additionally, our results highlight the importance of guidelines-directed medical therapy (GDMT) for HF exacerbation, a low threshold for use of NIPPV in obese patients, promotion of lifestyle modifications including weight loss, and early follow-up after discharge to prevent HF readmissions in the obese population.
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