Division of Cardiology, Department of Internal Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seongnam, Republic of Korea.
BMJ Open. 2019 Jul 10;9(7):e028741. doi: 10.1136/bmjopen-2018-028741.
To date, no research has investigated the association between cardiac complication and electrical injury; hence, we aimed to assess the consequences and relating factors of cardiac complications from electrical injuries in South Korea.
Retrospective single-centre study.
721 patients who had electrical injury-related admission during 2007-2017. An electronic medical record system was used to extract records of patients admitted for electrical injury treatment.
Cardiac complications included abnormal parameters of myocardial damage, abnormal regional wall motion detected via echocardiogram, dysrhythmia (eg, bradycardia, atrial flutter/fibrillation) and ventricular tachycardia or fibrillation. Overall, 107 patients (14.8%) experienced cardiac complications. The average admission duration and intensive care unit stay duration were significantly longer in patients with cardiac complications than in those without them (75.0±45.3 vs 56.6±48.0 days and 19.3±24.1 vs 10.4±15.5 days, respectively, p<0.01 for both). Of the total cardiac cases, 72.9% had Troponin I elevation, 3.7% had regional wall motion abnormality, and 5.6% had atrial flutter/fibrillation. Overall, seven patients from the cardiac complication group and three patients from the control group died (p0.01). All deaths occurred within 32 days, and the most common cause of death was septic shock. Total body surface area (TBSA) was only positively related factor to cardiac complications.
This study is the first in South Korea to reveal that electrical accident patients with cardiac complications experience poorer in-hospital prognosis, and TBSA was the only risk factor of cardiac complications. And initial treatment for infection and inflammations could be important in electrical injury.
迄今为止，尚无研究调查心脏并发症与电损伤之间的关系；因此，我们旨在评估韩国电损伤相关心脏并发症的后果及其相关因素。
回顾性单中心研究。
2007 年至 2017 年间因电损伤相关入院的 721 名患者。使用电子病历系统提取因电损伤治疗而入院的患者记录。
心脏并发症包括心肌损伤的异常参数、超声心动图检测到的异常节段壁运动、心律失常（如心动过缓、心房扑动/颤动）和室性心动过速或颤动。总体而言，107 名患者（14.8%）出现心脏并发症。有心脏并发症的患者的平均住院时间和重症监护病房住院时间明显长于无心脏并发症的患者（75.0±45.3 天 vs 56.6±48.0 天和 19.3±24.1 天 vs 10.4±15.5 天，均<0.01）。在所有心脏病例中，72.9%的肌钙蛋白 I 升高，3.7%的局部壁运动异常，5.6%的心房扑动/颤动。总的来说，心脏并发症组有 7 名患者和对照组有 3 名患者死亡（p<0.01）。所有死亡均发生在 32 天内，最常见的死亡原因是感染性休克。总体表面积（TBSA）是唯一与心脏并发症相关的阳性因素。
本研究是韩国首次揭示心脏并发症的电损伤患者住院预后较差，且 TBSA 是心脏并发症的唯一危险因素。对于电损伤患者，感染和炎症的初始治疗可能很重要。
