Jackson Inimfon, Etuk Aniekeme, Jackson Nsikak
Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA.
Department of Internal Medicine, Thomas Hospital Infirmary Health, Fairhope, AL, USA.
Am J Med Sci. 2023 Jan;365(1):56-62. doi: 10.1016/j.amjms.2022.08.011. Epub 2022 Aug 27.
Diffuse large B-cell lymphoma (DLBCL) patients have been reported to have cardiac manifestations, however, arrhythmias have not been characterized in this population. We examined the predictors of arrhythmias and assessed the impact of arrhythmias on inpatient outcomes among DLBCL patients.
Retrospective cohort analysis was performed using the National Inpatient Sample data collected between 2016 and 2018. Multivariable logistic and linear regression models were used to examine the predictors of arrhythmias and inpatient outcomes among DLBCL patients.
11% of DLBCL patients had a diagnosis of arrhythmias. Patients aged 70 years or older had 2.6 times higher odds (95% CI: 2.37-2.78) of having arrhythmias compared to patients younger than 70 years. Females were 23% (AOR: 0.77; 95% CI: 0.71-0.83) less likely to have a diagnosis of arrhythmias relative to their male counterparts. Compared to non-Hispanic whites, patients who were non-Hispanic blacks (AOR: 0.69; 95% CI: 0.60-0.81), Hispanics (AOR: 0.60; 95% CI: 0.52-0.69) or in the non-Hispanic other category (AOR: 0.80; 95% CI: 0.70-0.91) were significantly less likely to be diagnosed with arrhythmias. Other factors that predicted arrhythmias were patient disposition and comorbidity index. Additionally, arrhythmias were associated with higher inpatient mortality, length of stay and hospital costs.
Older male patients were more likely to be diagnosed with arrhythmias while non-Hispanic blacks and Hispanics were less likely to have arrhythmias. These findings highlight the need for surveillance to enable early detection of arrhythmias in this population.
据报道，弥漫性大B细胞淋巴瘤（DLBCL）患者存在心脏表现，然而，该人群中的心律失常情况尚未得到明确描述。我们研究了心律失常的预测因素，并评估了心律失常对DLBCL患者住院结局的影响。
使用2016年至2018年收集的全国住院患者样本数据进行回顾性队列分析。采用多变量逻辑回归和线性回归模型来研究DLBCL患者心律失常的预测因素和住院结局。
11%的DLBCL患者被诊断为心律失常。与70岁以下患者相比，70岁及以上患者发生心律失常的几率高2.6倍（95%置信区间：2.37 - 2.78）。相对于男性，女性被诊断为心律失常的可能性低23%（调整后比值比：0.77；95%置信区间：0.71 - 0.83）。与非西班牙裔白人相比，非西班牙裔黑人（调整后比值比：0.69；95%置信区间：0.60 - 0.81）、西班牙裔（调整后比值比：0.60；95%置信区间：0.52 - 0.69）或非西班牙裔其他类别（调整后比值比：0.80；95%置信区间：0.70 - 0.91）的患者被诊断为心律失常的可能性显著降低。预测心律失常的其他因素包括患者处置情况和合并症指数。此外，心律失常与更高的住院死亡率、住院时间和住院费用相关。
老年男性患者更易被诊断为心律失常，而非西班牙裔黑人和西班牙裔患者患心律失常的可能性较小。这些发现凸显了对此人群进行监测以实现心律失常早期检测的必要性。
