Ruiz-Bailén M, Pola Gallego M D, Expósito Ruiz M, Pintor Mármol A, Issa-Khozouz Z, Aguayo De Hoyos E, Rucabado-Aguilar L, Castillo-Rivera A M, Morante-Valle A, Rodríguez-Puche J A, García-Alcántara A, Gómez Jiménez F J
Unidad de Medicina Intensiva, Servicio de Cuidados Críticos y Urgencias, Hospital Universitario Médico Quirúrgico, Complejo Hospitalario de Jaén, Jaén, España.
Med Intensiva. 2006 Dec;30(9):432-9. doi: 10.1016/s0210-5691(06)74566-1.
Describe the frequency of high degree atrioventricular block (HDAVB) in patients with unstable angina (UA), analyze the variables associated with their appearance and evaluate whether HDAVB is independently associated with increased mortality or increased length of ICU stay.
Retrospective descriptive study of patients with UA included in the ARIAM registry.
ICUs from 129 hospitals in Spain.
From June 1996 to December 2003 a total of 14,096 patients were included in the ARIAM registry with a diagnosis of UA.
Variables associated with the development of HDAVB, variables associated with the mortality of patients with UA, variables associated with the length of ICU stay of patients with UA.
HDAVB frequency was 1%. Development of HDAVB was independently associated with the Killip classification and the presence of sustained ventricular tachycardia or ventricular fibrillation. Crude mortality of patients was significantly increased when HDAVB was present (9% versus 1%, p < 0,001). When adjusted for other variables, HDAVB was not associated with increased mortality. Development of HDAVB in patients with UA was independently associated with an increase in the length of ICU stay (adjusted odds ratio 1.89: 95% confidence interval: 1.33-5.69).
Patients with UA complicated with HDAVB represent a high-risk population with an increased ICU stay.
描述不稳定型心绞痛(UA)患者中高度房室传导阻滞(HDAVB)的发生率,分析与其出现相关的变量,并评估HDAVB是否与死亡率增加或重症监护病房(ICU)住院时间延长独立相关。
对纳入ARIAM注册研究的UA患者进行回顾性描述性研究。
西班牙129家医院的重症监护病房。
1996年6月至2003年12月,ARIAM注册研究共纳入14096例诊断为UA的患者。
与HDAVB发生相关的变量、与UA患者死亡率相关的变量、与UA患者ICU住院时间相关的变量。
HDAVB发生率为1%。HDAVB的发生与Killip分级以及持续性室性心动过速或心室颤动的存在独立相关。存在HDAVB时患者的粗死亡率显著增加(9%对1%,p<0.001)。在对其他变量进行校正后,HDAVB与死亡率增加无关。UA患者发生HDAVB与ICU住院时间延长独立相关(校正比值比1.89:95%置信区间:1.33 - 5.69)。
合并HDAVB的UA患者是ICU住院时间延长的高危人群。