Cardiology Department, Maggiore Hospital, Bologna, Italy.
J Cardiovasc Med (Hagerstown). 2010 Jun;11(6):450-61. doi: 10.2459/JCM.0b013e328335233e.
Intensive cardiac care units (ICCUs) have shifted from the observation of patients with myocardial infarction to the care of different acute cardiac diseases. However, few data on such an evolution are available.
From 7 to 20 April 2008, 6986 consecutive patients admitted to 81% of Italian ICCUs were prospectively enrolled. Patients observed were mainly elderly men (median age 72 years) with several co-morbidities. Most of them were triaged to ICCU from the emergency room, but 15% of admissions were transfer-in from other hospitals. Several diagnostic and therapeutic procedures were applied (78% had echocardiography and 35% coronary angiography) during the ICCU stay [median length 4 days, interquartile range (IQR) 2-5]. The discharge diagnosis was ST-elevation acute coronary syndrome (ACS) in 21%, non-ST-elevation ACS in 31%, acute heart failure (AHF) in 14% and other acute non-ACS, non-AHF cardiac diseases in 34%. Of those with ST-elevation ACS, 60% received reperfusion (15% fibrinolysis and 45% primary percutaneous coronary intervention). The overall in-ICCU crude mortality was 3.3%.
The BLITZ-3 survey provides a unique snapshot of current epidemiology and patterns of care of patients admitted to ICCUs. Although ACS still remains the most frequent admission diagnosis, the number of non-ACS patients is substantial. However, the correct standard of care for these non-ACS patients has to be defined.
重症心脏监护病房（ICCU）已从观察心肌梗死患者转变为治疗各种急性心脏疾病。然而，目前关于这种演变的数据很少。
2008 年 4 月 7 日至 20 日，连续前瞻性纳入了 81%的意大利 ICCU 中收治的 6986 例连续患者。观察到的患者主要是老年男性（中位年龄 72 岁），伴有多种合并症。他们中的大多数是从急诊室分诊到 ICCU，但有 15%的入院是从其他医院转来的。在 ICCU 住院期间进行了多种诊断和治疗程序（78%进行了超声心动图检查，35%进行了冠状动脉造影）[中位数住院时间为 4 天，四分位间距（IQR）为 2-5 天]。出院诊断为 ST 段抬高型急性冠状动脉综合征（ACS）占 21%，非 ST 段抬高型 ACS 占 31%，急性心力衰竭（AHF）占 14%，其他急性非 ACS、非 AHF 心脏疾病占 34%。在 ST 段抬高型 ACS 患者中，60%接受了再灌注治疗（15%溶栓治疗，45%直接经皮冠状动脉介入治疗）。ICCU 内的总死亡率为 3.3%。
BLITZ-3 调查提供了当前 ICU 收治患者的流行病学和治疗模式的独特快照。尽管 ACS 仍然是最常见的入院诊断，但非 ACS 患者的数量相当多。然而，这些非 ACS 患者的正确治疗标准尚待确定。
