评估圣保罗医院千禧医学学院心血管疾病入院人数和结局的规模和范围：一项回顾性研究。
Assessment of magnitude and spectrum of cardiovascular disease admissions and outcomes in Saint Paul Hospital Millennium Medical College, Addis Ababa: A retrospective study.
机构信息
Department of Physiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Internal Medicine, Yekatit-12 Hospital Medical College, Addis Ababa, Ethiopia.
出版信息
PLoS One. 2022 Dec 12;17(12):e0267527. doi: 10.1371/journal.pone.0267527. eCollection 2022.
BACKGROUND
Cardiovascular diseases(CVD) remain the leading cause of death in the world and over 80% of all cardiovascular-related deaths occur in low and middle income countries. Ethiopia is in epidemiologic transition from predominantly infectious diseases to non-communicable diseases and the CVD is a major public health challenge.
METHODS
The aim of this study was to assess the magnitude and spectrum of cardiovascular admission and its outcomes among medical patients admitted to both Medical Ward and ICU of St. Paul Teaching Hospital from 1st of Jan 2020 to 1st of Jan 2021.
RESULTS
Out of 1,165 annual medical admissions, the prevalence of cardiovascular diseases(CVD) was 30.3%. About 60%(212) of patients had advanced congestive heart failure of diverse causes. Hypertensive heart disease (HHD) was the next predominant diagnosis (41%(146)), and also the leading cause of cardiac diseases followed by rheumatic valvular heart disease(RVHD) (18%(64)) and Ischemic heart disease (IHD) (12.2%(43)), respectively. Yong age, rural residence and female sex were associated with RVHD(p = 0.001). Stroke also accounted for 20%(70) of CVD admission (hemorrhagic stroke-17% Vs Ischemic stroke-83%). Hypertension was the predominate risk factor for CVD and present in 46.7%(168) of patients. The mean hospital stay was 12days and in-hospital mortality rate was 24.3% with septic shock being the commonest immediate cause of death followed by fatal arrhythmia, brain herniation, and massive PTE.
CONCLUSION
Cardiovascular diseases were common in the study area causing significant morbidity and mortality. Therefore, comprehensive approach is imperative to timely screen for cardiovascular risk reduction, disease control and complication prevention. Strategies should also be designed to increase public awareness regarding the cardiovascular risk reduction, drug adherence, and possible complications.
背景
心血管疾病（CVD）仍然是世界上导致死亡的主要原因，超过 80%的心血管相关死亡发生在中低收入国家。埃塞俄比亚正处于从以传染病为主向非传染性疾病为主的流行病学转变中，心血管疾病是主要的公共卫生挑战。
方法
本研究旨在评估 2020 年 1 月 1 日至 2021 年 1 月 1 日期间，在圣保罗教学医院内科病房和 ICU 住院的内科患者中心血管疾病的发病情况及其结局。
结果
在 1165 例年度内科住院患者中，心血管疾病（CVD）的患病率为 30.3%。约 60%（212 例）的患者患有各种原因引起的晚期充血性心力衰竭。高血压性心脏病（HHD）是下一个主要诊断（41%（146 例）），也是心脏病的主要病因，其次是风湿性瓣膜性心脏病（RVHD）（18%（64 例））和缺血性心脏病（IHD）（12.2%（43 例））。年轻、农村居住和女性与 RVHD 相关（p=0.001）。中风也占 CVD 入院的 20%（70 例）（出血性中风 17%，缺血性中风 83%）。高血压是 CVD 的主要危险因素，在 46.7%（168 例）的患者中存在。平均住院时间为 12 天，住院死亡率为 24.3%，以感染性休克为最常见的即时死亡原因，其次是致命性心律失常、脑疝和大面积 PTE。
结论
心血管疾病在研究地区很常见，导致发病率和死亡率显著增加。因此，必须采取综合方法，及时筛查心血管疾病风险降低、疾病控制和并发症预防。还应制定策略，提高公众对心血管疾病风险降低、药物依从性和可能并发症的认识。
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