Cardelli Laura Sofia, Delbaere Quentin, Massin François, Granier Mathieu, Casella Gianni, Barbato Gaetano, Dupasquier Valentin, Macia Jean-Christophe, Leclercq Florence, Pasquie Jean-Luc, Roubille François
Cardiology Department, Ospedale Maggiore, 40100 Bologna, Italy.
Cardiology Department, Arnaud-De-Villeneuve Hospital, 34090 Montpellier, France.
J Clin Med. 2023 Jul 25;12(15):4884. doi: 10.3390/jcm12154884.
The wearable cardioverter defibrillator (WCD) has been proven to be effective in preventing sudden cardiac death (SCD) in patients soon after acute myocardial infarction (AMI) and left ventricular ejection fraction (LVEF) ≤35%. The aim of this study was to assess whether a WCD may shorten the length of an initial hospital stay (total length, days in the intensive care unit (ICU) and in the acute cardiac care unit (ACCU)) among these patients. This was a single-centre, retrospective observational study of patients referred for the management of SCD risk post-AMI and LVEF ≤35%, in a tertiary care hospital. The clinical characteristics and length of index hospitalization of the group of patients discharged, with or without WCD, were compared. A propensity score analysis was performed, then weighted regression models were conducted. A total of 101 patients in the WCD group and 29 in the control group were enrolled in the analysis. In the weighted regression models, WCD significantly reduced the days spent in ACCU ( < 0.001). WCD patients had significantly fewer days spent in ACCU (5.5 ± 2.6 vs. 8.4 ± 12.8 days, < 0.001) and shorter hospitalizations (10.2 ± 5.7 vs. 13.4 ± 17.6 days, = 0.005), compared with the control group. It was concluded that the WCD appears to reduce the total length of hospitalization and lengths of stay in ACCU for patients post-AMI and with left ventricular dysfunction.
可穿戴式心脏复律除颤器（WCD）已被证明在预防急性心肌梗死（AMI）后不久且左心室射血分数（LVEF）≤35%的患者心脏性猝死（SCD）方面有效。本研究的目的是评估WCD是否可缩短这些患者首次住院的时长（总时长、在重症监护病房（ICU）和急性心脏护理病房（ACCU）的天数）。这是一项在三级医院对因AMI后SCD风险及LVEF≤35%而转诊的患者进行的单中心回顾性观察研究。比较了出院时使用或未使用WCD的患者组的临床特征和索引住院时长。进行了倾向评分分析，然后构建了加权回归模型。分析纳入了WCD组的101例患者和对照组的29例患者。在加权回归模型中，WCD显著减少了在ACCU的天数（<0.001）。与对照组相比，使用WCD的患者在ACCU的天数显著更少（5.5±2.6天对8.4±12.8天，<0.001），住院时间更短（10.2±5.7天对13.4±17.6天，=0.005）。得出的结论是，WCD似乎可减少AMI后左心室功能不全患者的总住院时长和在ACCU的住院时长。
