Murman David H, McDonald Alden J, Pelletier Andrea J, Camargo Carlos A
Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Acad Emerg Med. 2007 Jun;14(6):578-81. doi: 10.1197/j.aem.2007.01.013. Epub 2007 Apr 20.
Supraventricular tachycardia (SVT) is often described as a recurrent condition that leads to emergency department (ED) visits. However, the epidemiology of ED visits for SVT is unknown.
To define the frequency of SVT in U.S. EDs and to analyze patient characteristics, ED management, and disposition for such visits.
The authors analyzed data from the National Hospital Ambulatory Medical Care Survey, 1993-2003. SVT cases were identified by using the International Classification of Diseases, Ninth Revision, Clinical Modification codes 426.7 or 427.0 in any of the three diagnostic fields.
Of the 1.1 billion ED visits over the 11-year study period, an estimated 555,000 (0.05%; 95% confidence interval [CI] = 0.04% to 0.06%) were related to SVT. The annual frequency and population rate appear stable between 1993 and 2003 (p for trend = 0.35). Compared with non-SVT visits, those with SVT were more likely to be older than 65 years of age (26% vs. 15%, p < 0.01) and female (70% vs. 53%, p < 0.01). Electrocardiograms were documented for most visits (91%; 95% CI = 85% to 96%). Approximately half of the patients (51%; 95% CI = 40% to 61%) received an atrioventricular nodal blocking medication, most frequently adenosine (26%; 95% CI = 17% to 36%). SVT visits ended in hospital admission for 24% (95% CI = 15% to 34%). At the other extreme, 44% (95% CI = 32% to 56%) were discharged without planned follow-up.
Supraventricular tachycardia accounts for approximately 50,000 ED visits each year. Higher visit rates in older adults and female patients are consistent with prior studies of SVT in the general population. This study provides an epidemiologic foundation that will enable future research to assess and improve clinical management strategies of SVT in the ED.
室上性心动过速（SVT）常被描述为一种导致患者前往急诊科（ED）就诊的复发性疾病。然而，关于因室上性心动过速前往急诊科就诊的流行病学情况尚不清楚。
确定美国急诊科室上性心动过速的发病频率，并分析此类就诊患者的特征、急诊科管理及处置情况。
作者分析了1993 - 2003年美国国家医院门诊医疗调查的数据。通过使用国际疾病分类第九版临床修订本编码426.7或427.0在三个诊断字段中的任何一个来识别室上性心动过速病例。
在11年的研究期间，11亿次急诊科就诊中，估计有55.5万次（0.05%；95%置信区间[CI]=0.04%至0.06%）与室上性心动过速有关。1993年至2003年间，年发病频率和人口发病率似乎保持稳定（趋势p值=0.35）。与非室上性心动过速就诊患者相比，室上性心动过速患者年龄≥65岁的可能性更大（26%对15%，p<0.01），女性患者更多（70%对53%，p<0.01）。大多数就诊患者（91%；95%CI=85%至96%）有心电图记录。约一半患者（51%；95%CI=40%至61%）接受了房室结阻滞药物治疗，最常用的是腺苷（26%；95%CI=17%至36%）。室上性心动过速就诊患者中有24%（95%CI=15%至34%）以住院告终。另一方面，44%（95%CI=32%至56%）患者出院时未安排随访。
室上性心动过速每年约导致5万次急诊科就诊。老年人和女性患者就诊率较高与之前普通人群室上性心动过速的研究结果一致。本研究提供了一个流行病学基础，有助于未来研究评估和改进急诊科室上性心动过速的临床管理策略。
