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地震对最常见紧急心脏状况的频率和预后的影响。

The impact of earthquakes on the frequency and prognosis of the most common emergency cardiac conditions.

机构信息

Zdravko Babić, Department of Cardiology, University Hospital Center Sestre Milosrdnice, Vinogradska cesta 29, 10000 Zagreb, Croatia,

出版信息

Croat Med J. 2023 Jun 30;64(3):164-169. doi: 10.3325/cmj.2023.64.164.

Abstract

AIM

To assess whether the number of patients with a cardiac chief complaint and their characteristics differed between before and after two major earthquakes that struck Croatia in 2020.

METHODS

We collected data on all visits of patients with a cardiac chief complaint examined in the emergency departments of six hospitals nearest to the epicenters. Patients seen during the 7 days before the earthquake were compared with those seen on the day and during the 6 days after the earthquake.

RESULTS

Patients seen after the earthquake were younger (68 [59-79] vs 72.5 [65-80]; P<0.001) and less frequently had cardiovascular disease (32.9% vs 42.8%; P<0.001). This group less frequently had the primary diagnosis of acute myocardial infarction (AMI) (15.6% vs 21.9%; P=0.005), heart failure (9.3% vs 19.4%; P<0.001), dysregulated hypertension (13.9% vs 19.4%; P=0.01), but more frequently had non-anginal chest discomfort (28.8% vs 18.0%; P<0.001). In a subgroup analysis of patients seen in hospitals located within 20 km from the epicenter, significantly more patients seen after the earthquake compared with those seen before the earthquake presented with AMI (14.5% vs 22.8%; P=0.028), acute elevation of blood pressure (10% vs 21.8%, P=0.001), and paroxysmal arrhythmias treated with electrocardioversion (0.9% vs 4.5%, P=0.022).

CONCLUSION

After two moderately strong earthquakes, hospitals within 20 km from the epicenter saw a significant increase in acute cardiac conditions such as elevated blood pressure, AMI, and cardioverted arrhythmias. Eventually, these earthquakes had no impact on the outcomes of the studied population.

摘要

目的

评估 2020 年克罗地亚发生的两次大地震前后,以心脏主诉就诊的患者数量及其特征是否存在差异。

方法

我们收集了距离震中最近的六家医院急诊科以心脏主诉就诊的所有患者的数据。将地震前 7 天就诊的患者与地震当天和之后 6 天就诊的患者进行比较。

结果

地震后就诊的患者年龄更小(68[59-79]岁 vs 72.5[65-80]岁;P<0.001),心血管疾病的发生率更低(32.9% vs 42.8%;P<0.001)。该组急性心肌梗死(AMI)的主要诊断率较低(15.6% vs 21.9%;P=0.005)、心力衰竭(9.3% vs 19.4%;P<0.001)、血压失调(13.9% vs 19.4%;P=0.01)的发生率较低,但非心绞痛性胸痛的发生率较高(28.8% vs 18.0%;P<0.001)。在距震中 20 公里内医院就诊患者的亚组分析中,地震后就诊的患者与地震前就诊的患者相比,AMI(14.5% vs 22.8%;P=0.028)、急性血压升高(10% vs 21.8%,P=0.001)和电复律治疗的阵发性心律失常(0.9% vs 4.5%,P=0.022)的发生率显著更高。

结论

在两次中等强度的地震后,距离震中 20 公里内的医院中,血压升高、AMI 和电复律治疗的心律失常等急性心脏疾病的就诊人数显著增加。最终,这些地震对研究人群的结局没有影响。

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