脑梗死住院30天内的心脏病再入院情况：利用全国再入院数据库对中风-心脏综合征的评估
Readmissions for Cardiac Disease Within 30 Days of Hospitalization for Cerebral Infarction: An Evaluation of the Stroke-Heart Syndrome Using the Nationwide Readmission Database.
作者信息
Kwok Chun Shing, Qureshi Adnan I, Borovac Josip Andelo, Will Maximilian, Schwarz Konstantin, Hall Mark, Mann Paul, Holroyd Eric, Lip Gregory Y H
机构信息
Department of Cardiology, Mid Cheshire Hospitals NHS Foundation Trust, Crewe CW1 4QJ, UK.
Zeenat Qureshi Stroke Institute, St. Cloud, MN 56303, USA.
出版信息
J Cardiovasc Dev Dis. 2025 Mar 26;12(4):116. doi: 10.3390/jcdd12040116.
BACKGROUND
The stroke-heart syndrome refers to incident cardiac complications post stroke. This study aims to evaluate the stroke-heart syndrome by determining the rate and predictors of readmission for cardiac disease within 30 days of hospitalization for cerebral infarction.
METHODS
Data from the United States Nationwide Readmissions Database (2018 to 2020) were analyzed to identify rates and factors associated with 30-day readmissions for heart disease following cerebral infarction, excluding patients with atrial fibrillation, heart failure and myocardial infarction during admission with cerebral infarction.
RESULTS
There were 3,115,850 hospital admissions for cerebral infarction, and 75,440 admissions (2.4%) were readmitted with new onset cardiac events within 30 days of discharge. This included 36,310 (1.4%) readmissions for heart failure, 35,900 (1.1%) readmissions for atrial fibrillation, 17,465 (0.5%) readmissions for acute myocardial infarction, 810 (0.03%) readmissions for ventricular arrhythmias and 700 (0.02%) readmissions for Takotsubo syndrome. Readmitted patients were older (median age of 73 years vs. 68 years, < 0.001) and had a longer length of stay for initial admission (median of 4 days vs. 3 days, < 0.001). The most significant predictors of readmission were elective admission (OR 2.00, 95%CI 1.89-2.13, < 0.001), cancer (OR 1.91, 95%CI 1.81-2.01, < 0.001), chronic kidney disease (OR 1.80, 95%CI 1.73-1.87, < 0.001), previous myocardial infarction (OR 1.59, 95%CI 1.50-1.69, < 0.001) and liver failure (OR 1.34, 95%CI 1.06-1.68, = 0.013). Palliative care was linked to a reduced odds of readmission (OR 0.36, 95%CI 0.31-0.41, < 0.001).
CONCLUSIONS
New cardiac-related hospital readmissions within 30 days after ischemic stroke occur in 2.4% of patients, with elective admission and cancer being a strong predictor of readmissions.
背景
卒中 - 心脏综合征是指卒中后发生的心脏并发症。本研究旨在通过确定脑梗死住院30天内心脏病再入院率及预测因素来评估卒中 - 心脏综合征。
方法
分析美国全国再入院数据库（2018年至2020年）的数据，以确定脑梗死患者30天内心脏病再入院率及相关因素，排除脑梗死入院时伴有心房颤动、心力衰竭和心肌梗死的患者。
结果
共有3115850例脑梗死住院患者，75440例（2.4%）在出院后30天内因新发心脏事件再次入院。其中包括因心力衰竭再次入院36310例（1.4%）、因心房颤动再次入院35900例（1.1%）、因急性心肌梗死再次入院17465例（0.5%）、因室性心律失常再次入院810例（0.03%）以及因应激性心肌病再次入院700例（0.02%）。再入院患者年龄更大（中位年龄73岁对68岁，P<0.001），首次住院时间更长（中位时间4天对3天，P<0.001）。再入院的最显著预测因素为择期入院（比值比2.00，95%置信区间1.89 - 2.13，P<0.001）、癌症（比值比1.91，95%置信区间1.81 - 2.01，P<0.001）、慢性肾病（比值比1.80，95%置信区间1.73 - 1.87，P<0.001）、既往心肌梗死（比值比1.59，95%置信区间1.50 - 1.69，P<0.001）和肝功能衰竭（比值比1.34，95%置信区间1.06 - 1.68，P = 0.013）。姑息治疗与再入院几率降低相关（比值比0.36，95%置信区间0.31 - 0.41，P<0.001）。
结论
缺血性卒中后30天内新发心脏相关再入院患者占2.4%，择期入院和癌症是再入院的强预测因素。
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