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因 SARS-CoV-2 住院人群中心律失常的预测因素。

Predictors of arrhythmias in the population hospitalized for SARS-CoV-2.

机构信息

Department of Internal Medicine, St. Luke's Hospital, St. Louis, MO, US.

Department of Internal Medicine, University of Massachusetts-Baystate Medical Center, Springfield, MA, USA.

出版信息

Curr Probl Cardiol. 2024 Nov;49(11):102792. doi: 10.1016/j.cpcardiol.2024.102792. Epub 2024 Aug 11.

Abstract

BACKGROUND

Studies exploring predictors of arrhythmias in the population primarily hospitalized for SARS-CoV-2 (COVID-19) are scarce. Understanding this is crucial for risk stratification and appropriate management.

METHODS

Using the 2020 National Inpatient Sample (NIS) database, we identified primary admissions for COVID-19. A 'greedy neighbor' 1:1 propensity-score matching (PSM) accounted for baseline differences. Then, multivariable logistic regression models were employed to account for confounders and estimate the probability of arrhythmia.

RESULTS

There were a total of 1,058,815 admissions for COVID-19 (mean age 64.3 years ±16.8), 47.2% female, 52.5% (107698) White, 18.5% (37973) Blacks, and 20.7% (42,447) Hispanics. Atrial fibrillation was the most prevalent arrhythmia, 15.1% (31,942). After PSM, 166,405 arrhythmia hospitalizations were matched to 166,405 hospitalizations without arrhythmia. Sick sinus syndrome 4.9 (4.4-5.5), dyslipidemia 1.2 (1.2-1.3), cardiac arrest 1.3 (1.1-1.4), invasive mechanical ventilation 1.9 (1.8-2.0) and obesity 1.3 (1.2-1.4), (p<0.0001, all) were all independent predictors of arrhythmias.

CONCLUSIONS

Our analysis revealed a notable proportion of hospitalized COVID-19 patients with arrhythmias. Dyslipidemia, obesity, sick sinus syndrome, invasive mechanical ventilation, and cardiac arrest were independent predictors of arrhythmias.

摘要

背景

目前针对因 SARS-CoV-2(COVID-19)住院的人群中心律失常预测因素的研究较为匮乏。了解这些因素对于风险分层和适当的管理至关重要。

方法

利用 2020 年国家住院患者样本(NIS)数据库,我们确定了 COVID-19 的主要入院病例。采用“贪婪邻居”1:1 倾向评分匹配(PSM)来消除基线差异。然后,使用多变量逻辑回归模型来考虑混杂因素并估计心律失常的概率。

结果

共有 1058815 例 COVID-19 住院患者(平均年龄 64.3 岁±16.8),其中 47.2%为女性,52.5%(107698 例)为白人,18.5%(37973 例)为黑人,20.7%(42447 例)为西班牙裔。最常见的心律失常是心房颤动,占 15.1%(31942 例)。在 PSM 后,166405 例心律失常住院患者与 166405 例无心律失常住院患者相匹配。病态窦房结综合征 4.9(4.4-5.5)、血脂异常 1.2(1.2-1.3)、心搏骤停 1.3(1.1-1.4)、有创机械通气 1.9(1.8-2.0)和肥胖 1.3(1.2-1.4)(均 P<0.0001)均是心律失常的独立预测因素。

结论

我们的分析显示,因 COVID-19 住院的患者中存在相当比例的心律失常患者。血脂异常、肥胖、病态窦房结综合征、有创机械通气和心搏骤停是心律失常的独立预测因素。

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