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围生期心肌病女性患者的并发症与年龄相关的差异。

Age-related disparities in complications among women with peripartum cardiomyopathy.

机构信息

Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom.

Independent Researcher, Triolet, Mauritius.

出版信息

Curr Probl Cardiol. 2024 Aug;49(8):102647. doi: 10.1016/j.cpcardiol.2024.102647. Epub 2024 May 25.

Abstract

INTRODUCTION

While the exact pathogenesis of peripartum cardiomyopathy, a potentially life-threatening condition, is still unknown, its incidence is rising globally. We sought to understand the differences in outcomes and complications based on age.

METHODS

Records from the 2016-2020 National Inpatient Sample were used for our study. The sample consisted of females diagnosed with peripartum cardiomyopathy that required hospitalization care. They were divided into two age-based cohorts: 15-29 years and 30-40 years. We evaluated differences in in-hospital complications between the two groups using multivariable regression.

RESULTS

The analysis consisted of 20520 females diagnosed with peripartum cardiomyopathy, of whom 57.3 % were in the 30-40 years cohort and 42.7 % in the 15-29 years group. The prevalence of cardiovascular risk factors such as smoking, obesity, hypertension, diabetes and lipid disorder was higher among women aged 30-40 years (p < 0.01). These patients also demonstrated higher odds of reporting acute ischemic stroke (aOR 1.354, 95 % CI 1.038-1.767, p = 0.026) while having a reduced risk of cardiogenic shock (aOR 0.787, 95 % CI 0.688-0.901, p < 0.01) as compared to those aged 15-29 years during their hospitalisation with PPCM. No statistically significant differences were noted for events of acute kidney injury (aOR 1.074, 95 % CI 0.976-1.182, p = 0.143), acute pulmonary oedema (aOR 1.147, 95 % CI 0.988-1.332, p = 0.071) or in-hospital mortality (aOR 0.978, 95 % CI 0.742-1.290, p = 0.877).

CONCLUSION

Peripartum cardiomyopathy is a serious condition that requires appropriate care and management. Our study linked cases of ages 30-40 years with increased odds of acute ischemic stroke but lower odds of cardiogenic shock.

摘要

介绍

尽管围产期心肌病的确切发病机制(一种潜在的危及生命的疾病)仍不清楚,但它在全球的发病率正在上升。我们试图根据年龄了解结局和并发症的差异。

方法

本研究使用了 2016-2020 年全国住院患者样本。样本包括被诊断患有围产期心肌病并需要住院治疗的女性。她们被分为两个年龄组:15-29 岁和 30-40 岁。我们使用多变量回归评估了两组患者住院期间并发症的差异。

结果

分析包括 20520 名被诊断患有围产期心肌病的女性,其中 57.3%为 30-40 岁年龄组,42.7%为 15-29 岁年龄组。心血管危险因素(如吸烟、肥胖、高血压、糖尿病和血脂异常)在 30-40 岁的女性中更为常见(p<0.01)。与 15-29 岁年龄组相比,这些患者在住院期间发生急性缺血性中风的几率更高(aOR 1.354,95%CI 1.038-1.767,p=0.026),而发生心源性休克的风险降低(aOR 0.787,95%CI 0.688-0.901,p<0.01)。两组患者在发生急性肾损伤(aOR 1.074,95%CI 0.976-1.182,p=0.143)、急性肺水肿(aOR 1.147,95%CI 0.988-1.332,p=0.071)或住院死亡率(aOR 0.978,95%CI 0.742-1.290,p=0.877)方面无统计学差异。

结论

围产期心肌病是一种严重的疾病,需要进行适当的治疗和管理。我们的研究将 30-40 岁年龄组的病例与急性缺血性中风的几率增加联系起来,但心源性休克的几率降低。

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