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叙利亚一家三级中心房颤住院后30天内的非计划再入院情况:一项真实世界观察性队列研究

Thirty-day unplanned readmissions following hospitalization for atrial fibrillation in a tertiary Syrian center: A real-world observational cohort study.

作者信息

Antoun Ibrahim, Alkhayer Alkassem, Aljabal Majed, Mahfoud Yaman, Alkhayer Alamer, Simon Peter, Kotb Ahmed, Barker Joseph, Mavilakandy Akash, Hani Rita, Somani Riyaz, Ng G André, Zakkar Mustafa

机构信息

Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.

Department of Medicine, Faculty of Medicine, University of Aleppo, Aleppo, Syria.

出版信息

Heart Rhythm O2. 2024 Jun 18;5(12):854-859. doi: 10.1016/j.hroo.2024.05.010. eCollection 2024 Dec.

Abstract

BACKGROUND

Atrial fibrillation (AF) is the most common arrhythmia worldwide. Data regarding 30-day readmission following index admission for AF in the developing world are poorly described.

OBJECTIVES

The study aimed to assess the rate, predictors, and trends of 30-day readmission after index admission for AF in Syria.

METHODS

We included adult patients who had an index admission with AF to Latakia's tertiary center between June 2021 and October 2023. Patients were monitored for readmission for 30 days after index discharge. Data were taken from patients' medical notes.

RESULTS

A total of 661 patients were included in the final analysis, of which 282 (43%) were readmitted to hospital within 30 days following index admission. Cardiac causes were the most common cause of readmission in 72% of patients, of which 60% were AF. Readmitted patients had a higher median age (62 years vs 57 years, .001), and there were fewer males (58% vs 51%, .001). In multivariate analysis, factors that independently increased 30-day readmission risk were older age (hazard ratio [HR] 1.5, 95% confidence interval [CI] 1.1-1.9), female sex (HR 1.3, 95% CI 1.02-1.4), diabetes mellitus (HR 1.7, 95% CI 1.3-2.3), and congestive heart failure (HR 2.2, 95% CI 1.7-2.9). Most cardiac readmissions happened during the first 15 days (79%).

CONCLUSION

Almost 1 in 2 patients were readmitted within 30 days after an index admission for AF. Female sex, advancing age, diabetes mellitus, and congestive heart failure were independently associated with an increased risk of 30-day readmission.

摘要

背景

心房颤动(AF)是全球最常见的心律失常。关于发展中世界房颤首次入院后30天再入院的数据描述不足。

目的

本研究旨在评估叙利亚房颤首次入院后30天再入院的发生率、预测因素和趋势。

方法

我们纳入了2021年6月至2023年10月期间在拉塔基亚三级中心首次因房颤入院的成年患者。患者在首次出院后接受30天的再入院监测。数据取自患者的病历。

结果

共有661例患者纳入最终分析,其中282例(43%)在首次入院后30天内再次入院。心脏原因是72%患者再入院的最常见原因,其中60%为房颤。再入院患者的年龄中位数较高(62岁对57岁,P <.001),男性较少(58%对51%,P <.001)。多因素分析中,独立增加30天再入院风险的因素为年龄较大(风险比[HR] 1.5,95%置信区间[CI] 1.1 - 1.9)、女性(HR 1.3,95% CI 1.02 - 1.4)、糖尿病(HR 1.7,95% CI 1.3 - 2.3)和充血性心力衰竭(HR 2.2,95% CI 1.7 - 2.9)。大多数心脏再入院发生在最初15天内(79%)。

结论

房颤首次入院后,近二分之一的患者在30天内再次入院。女性、年龄增长、糖尿病和充血性心力衰竭与30天再入院风险增加独立相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a756/11721721/604d401c8c22/gr1.jpg

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