急诊科窦性与非窦性心动过速：年龄及心率的重要性
Sinus versus nonsinus tachycardia in the emergency department: importance of age and heart rate.
作者信息
Pinto Duane S, Ho Kalon K, Zimetbaum Peter J, Pedan Alexander, Goldberger Ary L
机构信息
Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
出版信息
BMC Cardiovasc Disord. 2003 Aug 5;3:7. doi: 10.1186/1471-2261-3-7.
BACKGROUND
The emergency department diagnosis of sinus versus nonsinus tachycardia is an important clinical challenge. The objective of this study was to identify subjects with a high prevalence of nonsinus tachycardia.
METHODS
Heart rate and cardiac rhythm were prospective reviewed in 500 consecutive patients with heart rate > or = 100 beats/min in a busy emergency department. A predictive model based on age and heart rate was then developed to identify the probability of nonsinus tachycardia.
RESULTS
As age and heart rate increased, nonsinus tachycardias became more frequent. The probability of nonsinus tachycardia in a subject > or = 71 years with heart rate > or = 141 beats/minute was 93%, compared to only three percent in a subject < or = 50 years with heart rate 100-120 beats/minute. A simple point score system based on age and heart rate helps predict the probability of sinus tachycardia versus nonsinus tachycardia.
CONCLUSION
Nonsinus tachycardia is significantly more common than sinus tachycardia in elderly patients in the emergency department. The diagnosis of sinus tachycardia becomes much less likely as age and heart rate increase.
背景
急诊科鉴别窦性与非窦性心动过速是一项重要的临床挑战。本研究的目的是识别非窦性心动过速患病率高的患者。
方法
对一家繁忙急诊科中500例心率≥100次/分钟的连续患者的心率和心律进行前瞻性评估。然后建立基于年龄和心率的预测模型，以确定非窦性心动过速的概率。
结果
随着年龄和心率的增加，非窦性心动过速变得更加频繁。年龄≥71岁且心率≥141次/分钟的患者发生非窦性心动过速的概率为93%，而年龄≤50岁且心率为100-120次/分钟的患者仅为3%。基于年龄和心率的简单积分系统有助于预测窦性心动过速与非窦性心动过速的概率。
结论
在急诊科老年患者中，非窦性心动过速比窦性心动过速明显更常见。随着年龄和心率的增加，窦性心动过速的诊断可能性大大降低。
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