Subahi Ahmed, Akintoye Emmanuel, Yassin Ahmed S, Abubakar Hossam, Adegbala Oluwole, Mishra Tushar, Abdelrahman Mohamed, Shokr Mohamed, Afonso Luis
Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan.
Department of Internal Medicine, Englewood Hospital and Medical Center, Seton Hall University-Hackensack Meridian School of Medicine, Englewood, New Jersey.
Clin Cardiol. 2019 Jan;42(1):26-31. doi: 10.1002/clc.23088. Epub 2019 Jan 3.
Atrial fibrillation (AF) is associated with increased all-cause mortality in the general population. However, the impact of AF on the in-hospital outcomes of acute myocarditis (AM) patients is not well characterized.
Patients (age ≥ 18 years) with a primary diagnosis of AM in the National Inpatient Sample from 2007 to 2014 were included, using the ICD-9-CM diagnostic codes. We compared the in-hospital outcomes between the AF group and propensity score-matched control group without AF.
AF was reported in 602 (9%) of the AM patients. Compared to those without AF, AM patients with AF experienced higher in-hospital mortality (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.1-2.7, P = 0.02). AF was associated with higher risk of cardiogenic shock (OR 1.9, 95% CI 1.3-2.8, P < 0.001), cardiac tamponade (OR 5.6, 95% CI 1.2-25.3, P = 0.002) and acute kidney injury (OR 1.6, 95% CI 1.1-2.1, P = 0.02). Furthermore, patients with AF were more likely to have non-routine hospital discharge (31.6% vs 38.4% P = 0.02), longer length of stay and higher cost of hospitalization.
AF was associated with increased risk of in-hospital mortality and complications in patients admitted to the hospital with acute myocarditis.
在普通人群中，心房颤动（AF）与全因死亡率增加相关。然而，AF对急性心肌炎（AM）患者住院结局的影响尚未得到充分描述。
纳入2007年至2014年美国国家住院样本中初步诊断为AM的患者（年龄≥18岁），使用ICD-9-CM诊断编码。我们比较了AF组和倾向评分匹配的无AF对照组的住院结局。
602例（9%）AM患者报告有AF。与无AF的患者相比，有AF的AM患者住院死亡率更高（比值比[OR]1.7，95%置信区间[CI]1.1 - 2.7，P = 0.02）。AF与心源性休克风险更高（OR 1.9，95% CI 1.3 - 2.8，P < 0.001）、心脏压塞（OR 5.6，95% CI 1.2 - 25.3，P = 0.002）和急性肾损伤（OR 1.6，95% CI 1.1 - 2.1，P = 0.02）相关。此外，有AF的患者更有可能非常规出院（31.6%对38.4%，P = 0.02），住院时间更长且住院费用更高。
AF与急性心肌炎住院患者的住院死亡率和并发症风险增加相关。
