Novotny Julia, Klein Matthias Michael, Haum Magda, Fichtner Stephanie Raphaela, Thienel Manuela Bernadette
Department of Medicine I, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Department of Neurology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Int J Emerg Med. 2022 Sep 13;15(1):49. doi: 10.1186/s12245-022-00453-1.
Symptoms caused by cardiac arrhythmia are common problems that lead to presentation to the emergency department. However, the prevalence of pathological heart rhythm in patients triaged for cardiac arrhythmia in the emergency department remains up to now unknown.
In this retrospective study, patients triaged for cardiac arrhythmia admitted to the interdisciplinary emergency department of the Ludwig-Maximilians University Hospital in Munich within 1 year were included. Subsequently, cardiac rhythm in the 12-lead electrocardiogram, clinical presentation, admission rate, and diagnosis at discharge was analyzed. A total of 558 out of 39,798 patients were triaged for cardiac arrhythmia. Of these 42.3% of patients showed a pathological heart rhythm on the initial electrocardiogram (66.9% atrial fibrillation, 16.5% atrial flutter, 16.5% others). About 80% presented in emergency severity index III (many resources are needed without critical vitals) conditions. Sixty-two percent of the pathological electrocardiogram group and 60% of the sinus rhythm group of patients were admitted to the hospital, and 34.7% with pathological electrocardiogram underwent invasive investigations (16.8% in the sinus rhythm group). In 43.4% of patients, the diagnosis of cardiac arrhythmia was already known from previous medical contacts.
A total of 1.8% of patients who presented to our interdisciplinary emergency department were triaged for cardiac arrhythmia. With 49.5%, the hospital admission rate was quite high but the patients presented to the emergency department in our cohort were rarely in critical condition. As a high percentage of our cohort had a history of cardiac arrhythmia, better outpatient management is needed for these patients to reduce emergency department visits and save resources.
心律失常引起的症状是导致患者前往急诊科就诊的常见问题。然而，目前急诊科因心律失常分诊的患者中病理性心律的患病率尚不清楚。
在这项回顾性研究中，纳入了1年内被分诊至慕尼黑路德维希 - 马克西米利安大学医院跨学科急诊科的因心律失常就诊的患者。随后，分析了12导联心电图中的心律、临床表现、入院率及出院诊断。在39798例患者中，共有558例因心律失常被分诊。其中，42.3%的患者在初始心电图上显示病理性心律（66.9%为房颤，16.5%为房扑，16.5%为其他）。约80%的患者以急诊严重程度指数III级（无需关键生命体征监测但需要大量资源）就诊。病理性心电图组62%的患者和窦性心律组60%的患者入院，病理性心电图组34.7%的患者接受了侵入性检查（窦性心律组为16.8%）。43.4%的患者心律失常诊断已在之前的医疗接触中已知。
在我们跨学科急诊科就诊的患者中，共有1.8%因心律失常被分诊。入院率为49.5%，相当高，但我们队列中的患者很少处于危急状态。由于我们队列中的很大一部分患者有心律失常病史，因此需要对这些患者进行更好的门诊管理，以减少急诊科就诊次数并节省资源。
