Department of Cardiology, Moi Teaching and Referral Hospital, Eldoret, KE.
Department of Medicine, Moi University School of Medicine, Eldoret, KE.
Glob Heart. 2023 Sep 21;18(1):50. doi: 10.5334/gh.1261. eCollection 2023.
Sustained arrhythmias are frequently encountered in cardiac care units (CCU), but their types and outcomes in Africa are unknown. Studies from high-income countries suggest arrhythmias are associated with worse outcomes.
To determine the types and proportion of cardiac arrhythmias among patients admitted to the CCU at Moi Teaching and Referral Hospital (MTRH), and to compare 30-day outcomes between patients with and without arrhythmias at the time of CCU admission.
We conducted a prospective study of a cohort of all patients admitted to MTRH-CCU between March and December 2021. They were stratified on the presence or absence of arrhythmia at the time of CCU admission, irrespective of whether it was the primary indication for CCU care or not. Clinical characteristics were collected using a structured questionnaire. Participants were followed up for 30 days. The primary outcome of interest was 30-day all-cause mortality. Secondary outcomes were 30-day all-cause readmission and length of hospital stay. The 30-day outcomes were compared between the patients with and without arrhythmia, with a value < 0.05 being considered statistically significant.
We enrolled 160 participants. The median age was 46 years (IQR 31, 68), and 95 (59.4%) were female. Seventy (43.8%) had a diagnosis of arrhythmia at admission, of whom 62 (88.6%) had supraventricular tachyarrhythmias, five (7.1%) had ventricular tachyarrhythmias, and three (4.3%) had bradyarrhythmia. Atrial fibrillation was the most common supraventricular tachyarrhythmia (82.3%). There was no statistically significant difference in the primary outcome of 30-day mortality between those who had arrhythmia at admission versus those without: 32.9% versus 30.0%, respectively ( = 0.64).
Supraventricular tachyarrhythmias were common in critically hospitalized cardiac patients in Western Kenya, with atrial fibrillation being the most common. Thirty-day all-cause mortality did not differ significantly between the group admitted with a diagnosis of arrhythmia and those without.
持续性心律失常在心脏监护病房（CCU）中经常遇到，但在非洲，其类型和结果尚不清楚。来自高收入国家的研究表明，心律失常与更差的预后相关。
确定在莫伊教学和转诊医院（MTRH）CCU 住院的患者中心律失常的类型和比例，并比较入院时伴有和不伴有心律失常的患者在 30 天内的结局。
我们对 2021 年 3 月至 12 月期间在 MTRH-CCU 住院的所有患者进行了一项前瞻性队列研究。根据入院时是否存在心律失常进行分层，无论心律失常是否为 CCU 护理的主要指征。使用结构化问卷收集临床特征。对参与者进行了 30 天的随访。主要结局为 30 天全因死亡率。次要结局为 30 天全因再入院和住院时间。比较有和无心律失常患者的 30 天结局，以 值<0.05 为有统计学意义。
我们纳入了 160 名参与者。中位年龄为 46 岁（IQR 31，68），95 名（59.4%）为女性。70 名（43.8%）入院时诊断为心律失常，其中 62 名（88.6%）患有室上性心动过速，5 名（7.1%）患有室性心动过速，3 名（4.3%）患有缓慢性心律失常。心房颤动是最常见的室上性心动过速（82.3%）。入院时存在心律失常与不存在心律失常的患者 30 天死亡率的主要结局无统计学差异：分别为 32.9%和 30.0%（ = 0.64）。
在肯尼亚西部的危重心血管病患者中，室上性心动过速很常见，其中心房颤动最为常见。入院时诊断为心律失常的患者与无心律失常的患者之间的全因 30 天死亡率无显著差异。
