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特定病毒感染诊断对诊断为心肌炎入院患者的住院死亡率、住院时间和费用的影响:一项基于全国住院患者样本的分析

The Influence of Diagnoses of Specific Viral Infections on In-Hospital Mortality, Length of Stay and Cost in Patients Admitted to Hospital with a Diagnosis of Myocarditis: An Analysis of the National Inpatient Sample.

作者信息

Kwok Chun Shing, Will Maximilian, Moertl Deddo, Qureshi Adnan I, Borovac Josip A

机构信息

Department of Post Qualifying Healthcare Practice, Birmingham City University, B15 3TN Birmingham, UK.

Department of Cardiology, University Hospitals of North Midlands NHS Trust, ST4 6QG Stoke-on-Trent, UK.

出版信息

Rev Cardiovasc Med. 2023 Jul 17;24(7):206. doi: 10.31083/j.rcm2407206. eCollection 2023 Jul.

Abstract

BACKGROUND

The influence of different viral infections in patients with myocarditis is unknown. Myocarditis is an inflammatory disease of heart muscle that is commonly caused by viruses. The impact of different viral infections in patients with myocarditis is unknown.

METHODS

We conducted a retrospective cohort study using data between 2016-2020 in the National Inpatient Sample in the USA to evaluate admissions with myocarditis and concomitant viral infection. The outcomes of in-hospital mortality, length of stay (LoS), and cost, among patients hospitalized for myocarditis was evaluated.

RESULTS

A total of 27,050 hospital admissions for myocarditis were included and 6750 (25.0%) had a co-diagnosis of viral infection. Patients with myocarditis and viral infection had significantly higher mortality compared to those without viral infection (23.6% . 4.4%, 0.001). Viral infection was associated with increased in-hospital mortality (odds ratio (OR) 2.03, 95% CI 1.51 to 2.73, 0.001), greater median LoS (7 . 3 days, 0.001) and median hospitalization cost ($21,445 . $11,596, 0.001), compared to patients without viral infection. The rate of death was greatest for patients with a diagnosis of coronavirus disease 2019 (COVID-19), viral pneumonia and herpes zoster, respiratory syncytial virus, chronic hepatitis, and influenza which was 36.0%, 34.3%, 27.3%, 21.4%, 20.0%, and 14.5%, respectively.

CONCLUSIONS

In conclusion, the diagnosis of viral infection is present in one in four patients hospitalized with myocarditis and is correlated with greater mortality, LoS, and in-hospital cost.

摘要

背景

不同病毒感染对心肌炎患者的影响尚不清楚。心肌炎是一种常见由病毒引起的心肌炎症性疾病。不同病毒感染对心肌炎患者的影响尚不清楚。

方法

我们进行了一项回顾性队列研究,使用美国国家住院样本2016 - 2020年间的数据来评估心肌炎合并病毒感染的住院情况。评估了因心肌炎住院患者的院内死亡率、住院时间(LoS)和费用等结局。

结果

共纳入27050例心肌炎住院病例,其中6750例(25.0%)同时诊断为病毒感染。与无病毒感染的患者相比,心肌炎合并病毒感染的患者死亡率显著更高(23.6%对4.4%,P<0.001)。与无病毒感染的患者相比,病毒感染与院内死亡率增加相关(比值比(OR)2.03,95%置信区间1.51至2.73,P<0.001),中位住院时间更长(7天对3天,P<0.001),中位住院费用更高(21445美元对11596美元,P<0.001)。诊断为2019冠状病毒病(COVID - 19)、病毒性肺炎、带状疱疹、呼吸道合胞病毒、慢性肝炎和流感的患者死亡率最高,分别为36.0%、34.3%、27.3%、21.4%、20.0%和14.5%。

结论

总之,四分之一因心肌炎住院的患者存在病毒感染诊断,且与更高的死亡率、住院时间和住院费用相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8e8/11266461/a79177b84385/2153-8174-24-7-206-g1.jpg

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