Department of Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA.
Division of Cardiology, Cardiovascular Research Unit, RWJ Barnabas Health, NBIMC, Newark, New Jersey, USA.
J Card Surg. 2021 Oct;36(10):3586-3592. doi: 10.1111/jocs.15862. Epub 2021 Jul 27.
Primary cardiac tumors (PCT) are rare, and their contemporary outcomes are not well characterized in the literature. We assessed temporal trends in patient characteristics and management of admissions for PCT in US hospitals.
Admissions with the principal diagnoses of a PCT (benign neoplasm of heart: ICD-9 212.7, ICD-10 D15.1; malignant neoplasm of heart: ICD-9 164.1, ICD-10 C38.0) between 2006 and 2017 were extracted from the National Inpatient Sample. Trends in demographics and clinical profiles were evaluated. We conducted descriptive analyses on the cohort and compared outcomes between those managed medically and surgically.
Between 2006 and 2017, 19,111 admissions had the primary diagnosis of a PCT. Of these, 91.1% were benign. Admissions were mostly female (65.0%), caucasian (72.0%), and aged more than 50 years (76.0%). The annual admission rate for PCT was similar from 2006 to 2017 (p trend > .05) and associated with congestive heart failure, diabetes, renal failure, and valvular lesions. PCTs were managed surgically in 12,811 (67.0%) of overall cases, 70.8% for benign and 28.3% for malignant tumors. Overall, the in-hospital mortality rate was 2.3%. Medically managed cases reported a 2.5% higher mortality (p < .001) than those surgically managed. Admissions with malignant tumors were more likely to expire during hospitalization than those with benign tumors (odds ratio, 9.75; 95% confidence interval 6.34-14.99; p < .001).
Admissions for primary cardiac tumors were primarily women or in their fifth or sixth decade of life. Surgical intervention is more commonly practiced and is associated with better in-hospital survival.
原发性心脏肿瘤(PCT)较为罕见,目前对其在文献中的当代结果特征尚未有充分描述。我们评估了美国医院中 PCT 患者特征和管理方面的时间趋势。
从国家住院患者样本中提取了 2006 年至 2017 年间主要诊断为 PCT(良性心脏肿瘤:ICD-9 212.7,ICD-10 D15.1;恶性心脏肿瘤:ICD-9 164.1,ICD-10 C38.0)的住院患者。评估了人口统计学和临床特征的趋势。我们对队列进行了描述性分析,并比较了接受药物治疗和手术治疗的患者的结局。
2006 年至 2017 年间,共有 19111 例患者的主要诊断为 PCT,其中 91.1%为良性。这些患者中,女性(65.0%)、白种人(72.0%)和年龄超过 50 岁的患者(76.0%)居多。2006 年至 2017 年期间,PCT 的年入院率相似(趋势检验 p>0.05),并与充血性心力衰竭、糖尿病、肾衰竭和瓣膜病变相关。12811 例(67.0%)整体患者接受了手术治疗,其中 70.8%为良性肿瘤,28.3%为恶性肿瘤。总的来说,住院患者死亡率为 2.3%。接受药物治疗的患者报告死亡率(2.5%)高于接受手术治疗的患者(p<0.001)。恶性肿瘤患者在住院期间死亡的可能性高于良性肿瘤患者(比值比,9.75;95%置信区间 6.34-14.99;p<0.001)。
原发性心脏肿瘤的住院患者主要为女性或处于 50 岁或 60 岁出头的年龄段。更常采用手术干预,且与更好的院内生存率相关。