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非心脏重症监护病房中心律失常的流行病学、危险因素及转归

Epidemiology, Risk Factors, and Outcome of Cardiac Dysrhythmias in a Noncardiac Intensive Care Unit.

作者信息

Savaie Mohsen, Sheikhi Yasaman, Baghbanian Reza, Soltani Farhad, Amiri Fereshteh, Hesam Saeed

机构信息

Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

SAGE Open Nurs. 2023 Mar 22;9:23779608231160932. doi: 10.1177/23779608231160932. eCollection 2023 Jan-Dec.

Abstract

INTRODUCTION

Several extrinsic factors contribute to the development of cardiac dysrhythmias. In intensive care unit (ICU) settings and among critically ill patients who are exposed to a large number of risk factors, cardiac disturbances are more common.

OBJECTIVES

This study aimed to examine the epidemiology, risk factors, and outcome of cardiac dysrhythmias in a non-cardiac ICU.

METHODS

This is a retrospective, single-center, observational study conducted in a tertiary noncardiac ICU at Imam Khomeini Hospital in Ahvaz, Iran. Out of the 360 adult patients aged 18 years and older who were admitted to ICU for longer than 24 h, 340 cases who met the study inclusion criteria were recruited between March 2018 until October 2018.

RESULTS

The most common nonsinus dysrhythmias were new-onset atrial fibrillation (NOAF) (12.9%) and ventricular tachycardia (21 patients-6.2%). According to our results, previous percutaneous coronary instrumentation, acute kidney injury, sepsis, and hyperkalemia act as risk factors in the development of cardiac dysrhythmias. Additionally, we found out that thyroid dysfunction and pneumonia can predict the development of NOAF in critically ill patients. The estimated mortality rate among patients with NOAF in this study was 15.7% ( < .05).

CONCLUSION

Cardiac dysrhythmias are common in ICU patients and treating the risk factors can help to prevent their development and improve patient management and outcome.

摘要

引言

多种外在因素会导致心律失常的发生。在重症监护病房(ICU)环境中以及在暴露于大量风险因素的危重症患者中,心脏紊乱更为常见。

目的

本研究旨在调查非心脏ICU中心律失常的流行病学、风险因素及转归。

方法

这是一项在伊朗阿瓦士伊玛目霍梅尼医院的三级非心脏ICU进行的回顾性、单中心观察性研究。在360名年龄18岁及以上、入住ICU超过24小时的成年患者中,2018年3月至2018年10月期间招募了340例符合研究纳入标准的病例。

结果

最常见的非窦性心律失常是新发房颤(NOAF)(12.9%)和室性心动过速(21例,占6.2%)。根据我们的结果,既往经皮冠状动脉介入治疗、急性肾损伤、脓毒症和高钾血症是心律失常发生的风险因素。此外,我们发现甲状腺功能障碍和肺炎可预测危重症患者发生NOAF。本研究中NOAF患者的估计死亡率为15.7%(P<0.05)。

结论

心律失常在ICU患者中很常见,治疗风险因素有助于预防其发生,并改善患者管理及转归。

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Atrial Fibrillation in the ICU.重症监护病房中的心房颤动。
Chest. 2018 Dec;154(6):1424-1434. doi: 10.1016/j.chest.2018.03.040. Epub 2018 Apr 6.

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