Marziano Y, Abutbul E, Sharabi A, Grossbard E, Berman A, Kassif-Lerner R, Barkai G, Hakim H, Segal G
Sheba Beyond, Virtual Hospital at Chaim Sheba Medical Center, Tel Hashomer, Israel.
University of Nicosia Faculty of Medicine, Cyprus.
Int J Cardiol Cardiovasc Risk Prev. 2023 Sep 23;19:200215. doi: 10.1016/j.ijcrp.2023.200215. eCollection 2023 Dec.
Hospital-at-Home (HAH) is a valid alternative for in-hospital stay for a wide variety of clinical indications. Occult myocardial injury, associated with acute illness, mainly occurs in patients with a background of non-obstructive coronary disease. The aim of this study was to describe the prevalence of this phenomenon in our HAH population.
A retrospective description and analysis of data collected for patients admitted to the Sheba beyond's HAH services during 14 months.
During a period of 14 months (7/10/21-6/12/22), blood troponin measurements were available for 213 patients (median age 78 years, 52% males) hospitalized mainly for infectious causes. The median HS (highly sensitive) troponin level was 7.7 ng/L (IQR = 13.2 ng/L) (the normal upper limit is 12 ng/L) with 31% of all patients demonstrating an abnormally increased troponin level (68/213). Of all patients, 64% had a background diagnosis of a cardiovascular disease (138/213), of whom, 49% had abnormal HS troponin levels (68/138). No patient suffered from acute cardiac function deterioration and no patient died during their hospital-at-home stay.
The prevalence of occult myocardial injury amongst elderly patients admitted to hospital-at-home stay for diagnoses other than myocardial infarction is relatively high but it is not associated with worse short-term clinical outcomes.
居家医院（HAH）对于多种临床指征而言是住院治疗的有效替代方案。隐匿性心肌损伤与急性疾病相关，主要发生在非阻塞性冠状动脉疾病患者中。本研究的目的是描述这一现象在我们的居家医院人群中的患病率。
对在14个月期间入住舍巴远程居家医院服务的患者收集的数据进行回顾性描述和分析。
在14个月期间（2021年10月7日至2022年12月6日），对主要因感染性病因住院的213名患者（中位年龄78岁，52%为男性）进行了血肌钙蛋白检测。高敏肌钙蛋白水平中位数为7.7 ng/L（四分位间距=13.2 ng/L）（正常上限为12 ng/L），所有患者中有31%（68/213）肌钙蛋白水平异常升高。所有患者中，64%（138/213）有心血管疾病背景诊断，其中49%（68/138）高敏肌钙蛋白水平异常。没有患者出现急性心功能恶化，也没有患者在居家住院期间死亡。
因非心肌梗死诊断而入住居家医院的老年患者中隐匿性心肌损伤的患病率相对较高，但与较差的短期临床结局无关。
