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美国心律失常住院治疗及合并酒精使用障碍的全国趋势。

National Trends of Arrhythmia Hospitalizations and Comorbid Alcohol Use Disorders in the United States.

作者信息

Ravat Virendrasinh, Ajibawo Temitope, Parvataneni Tarun, Pereira Kristal N, Yen Ting Yu, Patel Rikinkumar S

机构信息

Internal Medicine, Krishna Institute of Medical Sciences, Karad, IND.

Internal Medicine, Brookdale University Hospital Medical Center, New York City, USA.

出版信息

Cureus. 2020 Jun 25;12(6):e8835. doi: 10.7759/cureus.8835.

Abstract

Objective To study the trends of arrhythmia hospitalizations with comorbid alcohol use disorders (AUDs) in terms of demographic characteristics and inpatient outcomes. Methods We used the Nationwide Inpatient Sample (NIS) data from 2010 to 2014 and included 570,556 arrhythmia inpatients (age, 15-54 years), and 55,730 inpatients had comorbid AUD. We used the linear-by-linear association test for measuring the differences in demographics, comorbidities, and hospital outcomes over the study period of 2010 to 2014, and the analysis of variance (ANOVA) for measuring the changes seen in the length of stay (LOS) and total charges. Results Arrhythmia inpatients with AUD were majorly males (85.9%), and older-age adults (45 to 54 years, 68%). Hypertension (52.2%), tobacco abuse (42.3%), and elevated cholesterol and lipids (22.6%) were the most prevalent comorbidities in the study population. There was a statistically significant increasing trend in arrhythmia inpatients with AUD with comorbid diabetes, hypertension, and obesity over the five-year period. In-hospital mortality had a variable trend from 1.1% in 2010 to 1.3% in 2014, but there was a statistically non-significant difference in the trend (P = 0.418). Mean LOS was three days with statistically no significant change during the study period (P = 0.080), whereas total charges have been increasing significantly (P <0.001), averaging $37,473 per hospitalization. Conclusion The prevalence trend of arrhythmia hospitalizations with comorbid AUD is increasing in the United States population, and is majorly seen in older-age men. Overall, in-hospital mortality in arrhythmia inpatients with comorbid AUD was 1.4%. So, this necessitates the development of an integrated clinical care model for early diagnosis and management of alcohol abuse and dependence in order to improve the arrhythmia patient outcomes and quality of life.

摘要

目的 研究合并酒精使用障碍(AUDs)的心律失常住院患者在人口统计学特征和住院结局方面的趋势。方法 我们使用了2010年至2014年的全国住院患者样本(NIS)数据,纳入了570,556名年龄在15至54岁的心律失常住院患者,其中55,730名患者合并AUD。我们使用线性-线性关联检验来衡量2010年至2014年研究期间人口统计学、合并症和医院结局的差异,并使用方差分析(ANOVA)来衡量住院时间(LOS)和总费用的变化。结果 合并AUD的心律失常住院患者主要为男性(85.9%)和老年人(45至54岁,68%)。高血压(52.2%)、烟草滥用(42.3%)和胆固醇及血脂升高(22.6%)是研究人群中最常见的合并症。在这五年期间,合并糖尿病、高血压和肥胖的合并AUD的心律失常住院患者有统计学上显著的增加趋势。住院死亡率从2010年的1.1%到2014年的1.3%呈可变趋势,但该趋势在统计学上无显著差异(P = 0.418)。平均住院时间为三天,在研究期间无统计学上的显著变化(P = 0.080),而总费用一直在显著增加(P <0.001),每次住院平均为37,473美元。结论 在美国人群中,合并AUD的心律失常住院患者的患病率呈上升趋势,主要见于老年男性。总体而言,合并AUD的心律失常住院患者的住院死亡率为1.4%。因此,有必要开发一种综合临床护理模式,用于酒精滥用和依赖的早期诊断和管理,以改善心律失常患者的结局和生活质量。

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