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巴西南部一家医院的急性冠状动脉综合征:周一住院人数达到峰值,周末和夜间出现重症病例。

Acute coronary syndrome in a hospital in southern Brazil: peak of hospitalizations on Mondays and severe cases on weekends and at night.

作者信息

Fernandes Bruno Felix, Kock Kelser de Souza

机构信息

University of Southern Santa Catarina (UNISUL), Medicine Course Tubarão, Santa Catarina, Brazil.

出版信息

Am J Cardiovasc Dis. 2022 Dec 15;12(6):307-314. eCollection 2022.

Abstract

INTRODUCTION

Ischemic heart disease is the leading cause of death in Brazil and worldwide. The term acute coronary syndrome (ACS) generically represents the acute myocardial ischemic events. These events are clinically divided into three types: acute myocardial infarction (AMI) with ST-segment elevation, AMI without ST-segment elevation, and unstable angina. Although cardiovascular ischemic events occur acutely, studies describe cyclic patterns of ACS, mainly on circadian and weekly variation.

OBJECTIVE

The aim of this study was to analyze the circadian and weekly variation of hospitalizations for ACS in a hospital in southern Brazil in 2019.

METHODS

Observational, cross-sectional type study. The population was the patients hospitalized at the Nossa Senhora da Conceição Hospital (NSCH) in Tubarão (SC, Brazil) with the international classification of diseases (ICD) code referring to ACS in the year 2019, corresponding to 579 patients.

RESULTS

After applying the exclusion criteria, 512 patients hospitalized for ACS were analyzed, 55.1% were male with a median (p25-p75) age of 62.0 (56.0-69.0) years. The main ICDs of hospitalization were: I20.0 (76.2%), I21.9 (16.6%), I21.3 (3.1%) and the most prevalent comorbidities were high blood pressure (82.6%), diabetes (30.1%) and previous AMI (23.6%). The median (p25-p75) time of admission was 14 h (10-18) h and length of stay was 5 (3-9) days. Death occurred in 18 hospitalizations (3.5%) of cases.

CONCLUSION

We conclude that in the present study there was a peak of hospitalizations for ACS on Mondays, proportionally reducing throughout the week and with a significant decrease on the weekend.

摘要

引言

缺血性心脏病是巴西乃至全球的主要死因。急性冠状动脉综合征(ACS)一词通常代表急性心肌缺血事件。这些事件在临床上分为三种类型:ST段抬高型急性心肌梗死(AMI)、非ST段抬高型AMI和不稳定型心绞痛。尽管心血管缺血事件是急性发生的,但研究描述了ACS的周期性模式,主要是昼夜和每周变化。

目的

本研究的目的是分析2019年巴西南部一家医院ACS住院患者的昼夜和每周变化情况。

方法

观察性横断面研究。研究对象为2019年在巴西圣卡塔琳娜州图巴朗的圣母受孕医院(NSCH)住院、国际疾病分类(ICD)代码涉及ACS的患者,共579例。

结果

应用排除标准后,分析了512例因ACS住院的患者,其中55.1%为男性,年龄中位数(第25-75百分位数)为62.0(56.0-69.0)岁。住院的主要ICD编码为:I20.0(76.2%)、I21.9(16.6%)、I21.3(3.1%),最常见的合并症为高血压(82.6%)、糖尿病(30.1%)和既往AMI(23.6%)。入院时间中位数(第25-75百分位数)为14小时(10-18小时),住院时间为5(3-9)天。18例(3.5%)患者死亡。

结论

我们得出结论,在本研究中,ACS住院患者在周一达到高峰,随后一周内按比例减少,周末显著下降。

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