Christus Ochsner St. Patrick Hospital, Lake Charles, USA.
University of Nevada, Reno School of Medicine, Reno, USA.
Clinics (Sao Paulo). 2023 Aug 7;78:100269. doi: 10.1016/j.clinsp.2023.100269. eCollection 2023.
The authors evaluated mortality and indices of cost of care among inpatients with Atrial Fibrillation (AF) and a diagnosis of a Temperature-Related Illness (TRI). The authors also assessed trends in the prevalence of TRIs among AF hospitalizations.
In this cross-sectional study, the authors used discharge data from the Nationwide Inpatient Sample (NIS) collected between January 2005 and September 2015 to identify patients with a diagnosis of AF and TRI. Outcomes of interest included in-hospital mortality, invasive mechanical ventilation, hospital length of stay, and cost of hospitalization.
A total of 37,933 encounters were included. The median age was 79 years. Males were slightly overrepresented relative to females (54.2% vs. 45.8%, respectively). Although Blacks were only 6.6% of the cohort, they represented 12.2% of the TRI cases. Compared to non-TRI-related hospitalizations, a diagnosis of a TRI was associated with an increased likelihood of invasive mechanical ventilation (16.5% vs. 4.1%, p < 0.001), longer length-of-stay (5 vs. 4 days, p < 0.001), higher cost of care (10,082 vs. 8,607, in US dollars p < 0.001), and increased mortality (18.6% vs. 5.1%, p < 0.001). Compared to non-TRI, cold-related illness portends higher odds of mortality 4.68, 95% Confidence Interval (4.35-5.04), p < 0.001, and heat-related illness was associated with less odds of mortality, but this was not statistically significant 0.77 (0.57-1.03), p = 0.88.
The occurrence of TRI among hospitalized AF patients is small but there is an increasing trend in the prevalence, which more than doubled over the decade in this study. Individuals with AF who are admitted with a TRI face significantly poorer outcomes than those admitted without a TRI including higher mortality. Cold-related illness is associated with higher odds of mortality. Further research is required to elucidate the pathogenic mechanisms underlying these findings and identify strategies to prevent TRIs in AF patients.
作者评估了患有心房颤动（AF）和体温相关疾病（TRI）诊断的住院患者的死亡率和护理成本指数。作者还评估了 AF 住院患者中 TRI 的患病率趋势。
在这项横断面研究中，作者使用了 2005 年 1 月至 2015 年 9 月期间全国住院患者样本（NIS）的数据，以确定患有 AF 和 TRI 诊断的患者。感兴趣的结果包括院内死亡率、有创机械通气、住院时间和住院费用。
共纳入 37933 例就诊。中位年龄为 79 岁。男性略多于女性（分别为 54.2%和 45.8%）。尽管黑人仅占队列的 6.6%，但他们占 TRI 病例的 12.2%。与非 TRI 相关的住院治疗相比，诊断为 TRI 与更高的有创机械通气可能性相关（16.5%比 4.1%，p<0.001），住院时间更长（5 天比 4 天，p<0.001），护理费用更高（10082 美元比 8607 美元，p<0.001），死亡率更高（18.6%比 5.1%，p<0.001）。与非 TRI 相比，冷相关疾病预示着更高的死亡率 4.68，95%置信区间（4.35-5.04），p<0.001，热相关疾病与较低的死亡率相关，但无统计学意义 0.77（0.57-1.03），p=0.88。
在住院 AF 患者中，TRI 的发生率虽然较小，但呈上升趋势，在这项研究中，十年来翻了一番多。患有 AF 并因 TRI 入院的患者的预后明显比未因 TRI 入院的患者差，包括死亡率更高。冷相关疾病与更高的死亡率相关。需要进一步研究阐明这些发现的发病机制，并确定预防 AF 患者发生 TRI 的策略。
