心房颤动对医院获得性肺炎患者院内死亡率的影响：一项观察性、按性别分层的研究。
The Influence of Atrial Fibrillation on In-Hospital Mortality in People with Hospital-Acquired Pneumonia: An Observational, Sex-Stratified Study.
作者信息
de Miguel-Yanes Jose M, Jimenez-Garcia Rodrigo, de Miguel-Diez Javier, Hernandez-Barrera Valentin, Mendez-Bailon Manuel, Zamorano-Leon Jose J, Lopez-de-Andres Ana
机构信息
Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain.
Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain.
出版信息
J Clin Med. 2022 Feb 22;11(5):1179. doi: 10.3390/jcm11051179.
(1) Background: The study aimed to analyze the influence of atrial fibrillation (AF) prior to hospital admission (“prevalent”) and new-onset AF diagnosed during hospital admission (“incident”) on in-hospital mortality (IHM) in women and men who developed hospital-acquired pneumonia (HAP) in Spain (2016−2019). (2) Methods: We used the Spanish Register of Specialized Care-Basic Minimum Database. (3) Results: We analyzed 38,814 cases of HAP (34.6% women; 13.5% ventilator-associated). Prevalent AF was coded in 19.9% (n = 7742), and incident AF in 5.5% (n = 2136) of HAP. Crude IHM was significantly higher for prevalent AF (34.22% vs. 27.35%, p < 0.001) and for incident AF (35.81% vs. 28.31%, p < 0.001) compared to no AF. After propensity score matching, IHM among women and men with prevalent AF was higher than among women and men with no AF (among women, 32.89% vs. 30.11%, p = 0.021; among men, 35.05% vs. 32.46%, p = 0.008). Similarly, IHM among women and men with incident AF was higher than among women and men with no AF (among women, 36.23% vs. 29.90%, p = 0.013; among men, 35.62% vs. 30.47%; p = 0.003). Sex was associated with a higher IHM only in people with incident AF (for female, OR = 1.21; 95% CI: 1.01−1.57). (4) Conclusions: Both prevalent and incident AF were associated with higher IHM in people who developed HAP. Female sex was associated with a higher IHM in incident AF.
(1) 背景：本研究旨在分析西班牙（2016 - 2019年）发生医院获得性肺炎（HAP）的男性和女性患者入院前房颤（“现患”）及入院期间诊断的新发房颤（“ incident”）对住院死亡率（IHM）的影响。(2) 方法：我们使用了西班牙专科护理基本最小数据库登记册。(3) 结果：我们分析了38814例HAP病例（女性占34.6%；呼吸机相关性肺炎占13.5%）。现患房颤在19.9%（n = 7742）的HAP病例中编码，新发房颤在5.5%（n = 2136）的HAP病例中编码。与无房颤相比，现患房颤的粗住院死亡率显著更高（34.22%对27.35%，p < 0.001），新发房颤的粗住院死亡率也显著更高（35.81%对28.31%，p < 0.001）。倾向评分匹配后，有现患房颤的男性和女性的住院死亡率高于无房颤的男性和女性（女性中，32.89%对30.11%，p = 0.021；男性中，35.05%对32.46%，p = 0.008）。同样，有新发房颤的男性和女性的住院死亡率高于无房颤的男性和女性（女性中，36.23%对29.90%，p = 0.013；男性中，35.62%对30.47%；p = 0.003）。仅在新发房颤患者中，性别与较高的住院死亡率相关（女性，OR = 1.21；95% CI：1.01 - 1.57）。(4) 结论：现患房颤和新发房颤均与发生HAP患者的较高住院死亡率相关。女性性别与新发房颤患者的较高住院死亡率相关。
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