Department of Pacing and Electrophysiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, China.
Chin Med J (Engl). 2019 Jan 5;132(1):17-24. doi: 10.1097/CM9.0000000000000010.
Little is known about the risk factors for sudden cardiac death (SCD) in the overall hospitalized cardiac department population. This study was conducted to investigate the risk factors and develop a predictive model for SCD in a hospitalized cardiac department population.
We conducted a retrospective study of patients admitted to the cardiac department of the First Affiliated Hospital of Xinjiang Medical University from June 2015 to February 2017. We collected the clinical data from medical records. Multiple stepwise logistic regression analysis was carried out to confirm the risk factors for SCD and develop a predictive risk model. The risk score was assessed by the area under receiver operating characteristic (AUROC) curve and the Hosmer-Lemeshow goodness-of-fit test.
A total of 262 patients with SCD and 4485 controls were enrolled in our study. Logistic regression modeling identified eight significant risk factors for in-hospital SCD: age, main admitting diagnosis, diabetes, corrected QT interval, QRS duration, ventricular premature beat burden, left ventricular ejection fraction, and estimated glomerular filtration rate. A predictive risk score including these variables showed an AUROC curve of 0.774 (95% confidence interval: 0.744-0.805). The Hosmer-Lemeshow goodness-of-fit test showed the chi-square value was 2.527 (P = 0.640). The incidence of in-hospital SCD was 1.3%, 4.1%, and 18.6% for scores of 0 to 2, 3 to 5 and ≥6, respectively (P < 0.001).
Age, main admitting diagnosis, diabetes, QTc interval, QRS duration, ventricular premature beat burden, left ventricular ejection fraction, and estimated glomerular filtration rate are factors related to in-hospital SCD in a hospitalized cardiac department population. We developed a predictive risk score including these factors that could identify patients who are predisposed to in-hospital SCD.
对于综合性心内科住院患者，人们对心脏性猝死（SCD）的危险因素知之甚少。本研究旨在调查心内科住院患者发生 SCD 的危险因素并建立预测模型。
本研究为回顾性研究，纳入 2015 年 6 月至 2017 年 2 月新疆医科大学第一附属医院心内科住院患者的临床资料。采用多因素逐步 logistic 回归分析明确 SCD 的危险因素并建立预测风险模型。采用受试者工作特征（ROC）曲线下面积（AUROC）和 Hosmer-Lemeshow 拟合优度检验评估风险评分。
共纳入 262 例 SCD 患者和 4485 例对照组。logistic 回归分析确定了 8 个与住院 SCD 相关的独立危险因素：年龄、主要入院诊断、糖尿病、校正 QT 间期（QTc）、QRS 波群时限、室性早搏负荷、左心室射血分数（LVEF）和估算肾小球滤过率（eGFR）。包含这些变量的预测风险评分的 AUROC 曲线为 0.774（95%可信区间：0.744-0.805）。Hosmer-Lemeshow 拟合优度检验显示卡方值为 2.527（P=0.640）。风险评分 0-2、3-5 和≥6 分患者的住院 SCD 发生率分别为 1.3%、4.1%和 18.6%（P<0.001）。
年龄、主要入院诊断、糖尿病、QTc 间期、QRS 波群时限、室性早搏负荷、LVEF 和 eGFR 是心内科住院患者发生 SCD 的相关因素。我们建立了包含这些因素的预测风险评分，可以识别易发生住院 SCD 的患者。
