Punnoose Ann R, Kaltman Jonathan R, Pastor William, McCarter Robert, He Jianping, Spurney Christopher F
Division of Cardiology, Lurie Children's Hospital of Chicago, 225 E Chicago Avenue, Chicago, IL, 60611, USA.
Division of Cardiology, Children's Hospital of Wisconsin, 8915 W. Connell Ct, P. O. Box 1997, Milwaukee, WI, 53226, USA.
Pediatr Cardiol. 2016 Oct;37(7):1290-6. doi: 10.1007/s00246-016-1432-5. Epub 2016 Jun 17.
As treatments of the extra-cardiac complications of muscular dystrophy (MD) improve, males with MD are more likely to develop cardiac disease. The impact of cardiomyopathy or heart failure (HF) and ventricular tachycardia (VT) on hospitalizations and in hospital mortality are not known. We performed an analysis of inpatient admission data for patients with MD using the Pediatric Health Information System database. We selected males who were 6 years or older with diagnosis codes of MD and cardiac disease including cardiomyopathy/HF and VT between 2003 and 2013. We created a logistic regression model to identify predictors of subsequent cardiac arrest or death in MD patients. We also compared hospital charges, lengths of stay and ages among MD patients with or without cardiac disease. Our logistic regression model showed that VT (OR 5.41, 95 % CI 2.83, 10.34) and cardiomyopathy/HF (OR 1.79, 95 % CI 1.05, 3.04) were risk factors for cardiac arrest or death. Of the 84 cardiac arrests or deaths in 3363 MD patients, 49 (58 %) were related to cardiac disease. Nineteen (39 %) of these events occurred in MD patients with VT. The mean hospital charges and the mean length of stay were greater and longer in MD patients with VT compared to those without cardiac disease and those with only cardiomyopathy/HF (p < 0.05). Cardiac disease is a significant burden in hospitalized MD patients. Our results suggest that VT and cardiomyopathy/HF are associated with an increased risk of cardiac arrest or death in MD patients.
随着对肌肉萎缩症（MD）心脏外并发症治疗的改善，患有MD的男性更易患心脏病。心肌病或心力衰竭（HF）以及室性心动过速（VT）对住院率和住院死亡率的影响尚不清楚。我们使用儿科健康信息系统数据库对MD患者的住院数据进行了分析。我们选取了2003年至2013年间年龄在6岁及以上、诊断代码为MD以及包括心肌病/HF和VT在内的心脏病的男性患者。我们创建了一个逻辑回归模型来确定MD患者后续心脏骤停或死亡的预测因素。我们还比较了有或没有心脏病的MD患者的住院费用、住院时间和年龄。我们的逻辑回归模型显示，VT（比值比5.41，95%可信区间2.83，10.34）和心肌病/HF（比值比1.79，95%可信区间1.05，3.04）是心脏骤停或死亡的危险因素。在3363例MD患者中的84例心脏骤停或死亡病例中，49例（58%）与心脏病有关。其中19例（39%）事件发生在患有VT的MD患者中。与没有心脏病和仅患有心肌病/HF的患者相比，患有VT的MD患者的平均住院费用更高，平均住院时间更长（p<0.05）。心脏病是住院MD患者的一项重大负担。我们的结果表明，VT和心肌病/HF与MD患者心脏骤停或死亡风险增加有关。
