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炎症性肠病与心律失常之间关联的调查:对美国国家住院样本数据库的分析

An Investigation into the Association Between Inflammatory Bowel Disease and Cardiac Arrhythmias: An Examination of the United States National Inpatient Sample Database.

作者信息

Mubasher Mahmood, Syed Tausif, Hanafi Amir, Yu Zhao, Yusuf Ibrahim, Abdullah Abdullah Sayied, Mohamed Mouhand Fh, Alweis Richard, Rao Mohan, Hoefen Ryan, Danjuma Mohammed I

机构信息

Department of Medicine, Unity Hospital, Rochester, NY, USA.

Department of Cardiology, Rochester Regional Health, Rochester, NY, USA.

出版信息

Clin Med Insights Cardiol. 2020 Oct 28;14:1179546820955179. doi: 10.1177/1179546820955179. eCollection 2020.

Abstract

BACKGROUND

Inflammatory bowel diseases (IBD) associated-chronic inflammation and autonomic dysregulation may predispose to arrhythmias. However, its exact prevalence is unknown. Thus, we aimed to ascertain the prevalence of arrhythmias in patients with IBD.

METHODS

We queried the Nationwide Inpatient Sample (the largest publicly available all-payer inpatient USA database) from 2012 to 2014. We used the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) discharge codes to identify adult patients (⩾18 years) with IBD and dysrhythmias (supraventricular tachycardia (SVT), atrial fibrillation, atrial flutter, ventricular tachycardia (VT), or ventricular fibrillation). Furthermore, we identified risk factors for cardiovascular disease. We divided patients into 2 cohorts, IBD cohorts, and non-IBD cohort. The independent effect of a diagnosis of IBD on the risk of dysrhythmias was examined using a multivariable logistic regression model controlling for multiple confounders.

RESULTS

We identified 847 235 and 84 757 349 weighted hospitalizations among patients with IBD and non-IBD cohorts, respectively. Patients with IBD were less likely to be hospitalized for dysrhythmias than the non-IBD (9.7% vs 14.2%,  < .001). The hospitalization odds for dysrhythmias among patients with IBD were less than the general population (OR 0.87; 95% CI 0.85-0.88). However, the prevalence of SVT and VT was indifferent between the 2 groups. Male sex, age of over 60, and white race were risk factors for dysrhythmias.

CONCLUSION

Despite prior reports of a higher prevalence of arrhythmias among patients with IBD, in a nationwide inpatient database, we found lower rates of hospitalization-related-arrhythmias in the IBD population compared to that of the general population.

摘要

背景

炎症性肠病(IBD)相关的慢性炎症和自主神经调节异常可能易导致心律失常。然而,其确切患病率尚不清楚。因此,我们旨在确定IBD患者中心律失常的患病率。

方法

我们查询了2012年至2014年的全国住院患者样本(美国最大的公开可用的全付费者住院数据库)。我们使用国际疾病分类第九版临床修订本(ICD-9 CM)出院编码来识别患有IBD和心律失常(室上性心动过速(SVT)、心房颤动、心房扑动、室性心动过速(VT)或心室颤动)的成年患者(≥18岁)。此外,我们确定了心血管疾病的危险因素。我们将患者分为两个队列,IBD队列和非IBD队列。使用控制多个混杂因素的多变量逻辑回归模型检查IBD诊断对心律失常风险的独立影响。

结果

我们分别在IBD队列和非IBD队列患者中确定了847235次和84757349次加权住院。IBD患者因心律失常住院的可能性低于非IBD患者(9.7%对14.2%,P<0.001)。IBD患者中心律失常的住院几率低于一般人群(OR 0.87;95%CI 0.85-0.88)。然而,两组之间SVT和VT的患病率无差异。男性、60岁以上年龄和白人种族是心律失常的危险因素。

结论

尽管先前有报道称IBD患者中心律失常的患病率较高,但在全国住院数据库中,我们发现IBD人群中与住院相关的心律失常发生率低于一般人群。

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