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血液系统恶性肿瘤患者急性心肌梗死的院内临床结局

Clinical In-Hospital Outcomes of Acute Myocardial Infarction in Patients With Hematological Malignancies.

作者信息

Khan Muhammad Z, Baqi Abdul, Patel Kirtenkumar, Weinstock Joshua, Franklin Sona, Kutalek Steven

机构信息

Cardiology, University Hospitals Cleveland Medical Center, Cleveland, USA.

Internal Medicine, St. Vincent Medical Center - Mercy Health, Toledo, USA.

出版信息

Cureus. 2022 Jan 26;14(1):e21627. doi: 10.7759/cureus.21627. eCollection 2022 Jan.

DOI:10.7759/cureus.21627
PMID:35228975
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8876845/
Abstract

Introduction The purpose of our study is to determine in-hospital outcomes of acute myocardial infarction in patients with hematological malignancies and their subtypes. Method Patient data were obtained from the nationwide inpatient sample (NIS) database between the years 2009-2014. Patients with hematological cancer subtypes and acute MI (non-ST segment elevation myocardial infarction and ST-segment elevation myocardial infarction (NSTEMI/STEMI) were identified using validated international classification of diseases (ninth revision) and clinical modification (ICD-9-CM) codes. Statistical analysis using the chi-square test was performed to determine the hospital outcomes of acute MI in patients with hematological cancers and subtypes. Results The prevalence of acute myocardial infarction was 2.4% in patients with hematological neoplasms (N=3,027,800). Amongst the subtypes of blood cancers, the highest prevalence of acute MI was seen in lymphocytic leukemia (2.9%). The mortality of MI in patients with hematological malignancies was 16.8% vs 8.8% in patients with non-hematological malignancies, in-hospital costs were $25469 ± 36763 vs. $20534 ± 24767, and length of in-hospital stay was 8.3 ± 10 vs 6.3 ± 7.8 days. Amongst the hematological cancer subtypes, the highest mortality of acute MI was found in myeloid leukemia (23%) followed by multiple myeloma (MM) (17.9%), lymphocytic leukemia (15.9%), and lymphoma (14.4%). The length of stay and hospitalization cost was highest for myeloid leukemia, followed by MM, lymphocytic leukemia, and lymphoma. Conclusion This study showed that acute MI in patients with hematological malignancies has higher in-hospital mortality, length of stay, and cost. Amongst the blood neoplasm subtypes the highest mortality, length of hospital stay, and hospitalization cost were found in myeloid leukemia.

摘要

引言 我们研究的目的是确定血液系统恶性肿瘤患者及其亚型急性心肌梗死的院内结局。方法 患者数据来自2009年至2014年的全国住院患者样本（NIS）数据库。使用经过验证的国际疾病分类（第九版）及临床修订版（ICD-9-CM）编码识别血液系统癌症亚型和急性心肌梗死（非ST段抬高型心肌梗死和ST段抬高型心肌梗死（NSTEMI/STEMI））患者。采用卡方检验进行统计分析，以确定血液系统癌症患者及其亚型急性心肌梗死的院内结局。结果 血液系统肿瘤患者急性心肌梗死的患病率为2.4%（N=3,027,800）。在血液癌症亚型中，急性心肌梗死患病率最高的是淋巴细胞白血病（2.9%）。血液系统恶性肿瘤患者心肌梗死的死亡率为16.8%，而非血液系统恶性肿瘤患者为8.8%；住院费用分别为25469±36763美元和20534±24767美元；住院时间分别为8.3±10天和6.3±7.8天。在血液系统癌症亚型中，急性心肌梗死死亡率最高的是髓细胞白血病（23%），其次是多发性骨髓瘤（MM）（17.9%）、淋巴细胞白血病（15.9%）和淋巴瘤（14.4%）。住院时间和住院费用以髓细胞白血病最高，其次是MM、淋巴细胞白血病和淋巴瘤。结论 本研究表明，血液系统恶性肿瘤患者急性心肌梗死的院内死亡率、住院时间和费用更高。在血液肿瘤亚型中，髓细胞白血病的死亡率、住院时间和住院费用最高。

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