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哮喘相关住院中心律失常的负担与影响:来自全国住院患者样本的见解

Burden and impact of arrhythmias in asthma-related hospitalizations: Insight from the national inpatient sample.

作者信息

Taha Muhanad, Mishra Tushar, Shokr Mohamed, Sharma Aditi, Taha Mazen, Samavati Lobelia

机构信息

Department of Internal Medicine Detroit Medical Centre/Wayne State University Detroit MI USA.

Cardiology Department Leon H. Charney Division of Cardiology, Cardiac Electrophysiology NYU Langone Health New York University Grossman School of Medicine New York NY USA.

出版信息

J Arrhythm. 2020 Nov 17;37(1):113-120. doi: 10.1002/joa3.12452. eCollection 2021 Feb.

Abstract

BACKGROUND

This study aimed to analyze the burden and impact of cardiac arrhythmias in adult patients hospitalized with asthma exacerbation using the nationwide inpatient database.

METHODS

We used the National Inpatient Sample (NIS) database (2010-2014) to identify arrhythmias in asthma-related hospitalization and its impact on inpatient mortality, hospital length of stay (LOS), and hospitalization charges. We also used multivariable analysis to identify predictors of in-hospital arrhythmia and mortality.

RESULTS

We identified 12,988,129 patients hospitalized with primary diagnosis of asthma; among them, 2,014,459(16%) patients had cardiac arrhythmia. The most frequent arrhythmia identified is atrial fibrillation (AFib) (8.95%). The AFib and non-AFib arrhythmia group had higher mortality (3.40% & 2.22% vs 0.74%), mean length of stay (LOS) (5.9 & 5.4 vs 4.2 days), and hospital charges ($53,172 & $51,105 vs $34,585) as compared to the non-arrhythmia group ( < .005). Predictors of arrhythmia in asthma-related hospitalization were history of PCI or CABG, valvular heart disease, congestive heart failure (CHF), and acute respiratory failure. Predictors of higher mortality in arrhythmia group were acute respiratory failure, sepsis, and acute myocardial infarction.

CONCLUSIONS

Around 16% of adult patients hospitalized with asthma exacerbation experience arrythmia (mostly AFib 8.95%). The presence of arrhythmias was associated with higher in-hospital mortality, LOS, and hospital charges in hospitalized asthmatics.

摘要

背景

本研究旨在利用全国住院患者数据库分析成年哮喘急性加重期住院患者心律失常的负担及影响。

方法

我们使用国家住院患者样本(NIS)数据库(2010 - 2014年)来确定哮喘相关住院患者中的心律失常情况及其对住院死亡率、住院时间(LOS)和住院费用的影响。我们还使用多变量分析来确定院内心律失常和死亡率的预测因素。

结果

我们确定了12,988,129例以哮喘为主诊断住院的患者;其中,2,014,459例(16%)患者有心律失常。最常见的心律失常是心房颤动(AFib)(8.95%)。与无心律失常组相比,AFib和非AFib心律失常组的死亡率更高(分别为3.40%和2.22%,而无心律失常组为0.74%),平均住院时间更长(分别为5.9天和5.4天,而无心律失常组为4.2天),住院费用更高(分别为53,172美元和51,105美元,而无心律失常组为34,585美元)(P <.005)。哮喘相关住院患者心律失常的预测因素为PCI或CABG病史、心脏瓣膜病、充血性心力衰竭(CHF)和急性呼吸衰竭。心律失常组较高死亡率的预测因素为急性呼吸衰竭、脓毒症和急性心肌梗死。

结论

约16%的成年哮喘急性加重期住院患者发生心律失常(大多数为AFib,占8.95%)。心律失常的存在与住院哮喘患者较高的院内死亡率、住院时间和住院费用相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1870/7896478/f958460c92a4/JOA3-37-113-g001.jpg

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