Kwan Timothy N, Ravindran Jayant, Alsadat Noor, Kwan Gemma, Brieger David, Chow Vincent, Kritharides Leonard, Ng Austin Chin Chwan
Department of Cardiology, Concord General Repatriation Hospital, The University of Sydney, Hospital Road, Concord, NSW 2139, Australia.
J Clin Med. 2025 Jun 10;14(12):4089. doi: 10.3390/jcm14124089.
Myocarditis is a life-threatening condition with an increasing incidence in the past two decades. Little is known about the frequency of specific causes of death following myocarditis. This study aimed to identify the different causes of death after myocarditis diagnosis and determine factors associated with mortality. We conducted a retrospective population-wide observational study in New South Wales (NSW), Australia from July 2004 to September 2021. Data were attained from the NSW Admitted Patient Data Collection database and death was tracked from the death registry to 31 March 2022. Cause of death was ascertained from manual reviews of all death certificates and adjudicated independently by three reviewers. Among 4071 unique index admissions for myocarditis (median age: 42 years; 66% male), cumulative all-cause mortality was 4.5% in-hospital, 8.2% at 1 year, 13.3% at 5 years and 15.5% by the end of follow up (median 5.3 years). Within 30 days of admission, the leading cause of death was cardiovascular (66%), including myocarditis (36%) and heart failure (12%). Non cardiovascular causes accounted for 32% of deaths and included infection (17%) and malignancy (6%). Beyond 30 days, cardiovascular deaths declined to 34% (only 3% due to myocarditis). Higher mortality risk was associated with older age, higher Charlson comorbidity index, and myocarditis complicated by intensive care unit admission, heart failure, stroke, or arrhythmia. Patients admitted with myocarditis face significant mortality risks. The highest mortality occurs within the first 30 days, predominantly due to cardiovascular causes, although after 30 days the predominant cause of death shifts to non-cardiovascular causes.
心肌炎是一种危及生命的疾病，在过去二十年中发病率不断上升。对于心肌炎后特定死亡原因的发生率知之甚少。本研究旨在确定心肌炎诊断后的不同死亡原因，并确定与死亡率相关的因素。我们于2004年7月至2021年9月在澳大利亚新南威尔士州（NSW）进行了一项全人群回顾性观察研究。数据来自新南威尔士州住院患者数据收集数据库，并从死亡登记处追踪至2022年3月31日。通过对所有死亡证明进行人工审核确定死亡原因，并由三名审核人员独立判定。在4071例心肌炎的独特索引入院病例中（中位年龄：42岁；66%为男性），住院期间全因累积死亡率为4.5%，1年时为8.2%，5年时为13.3%，随访结束时（中位5.3年）为15.5%。入院后30天内，主要死亡原因是心血管疾病（66%），包括心肌炎（36%）和心力衰竭（12%）。非心血管原因占死亡人数的32%，包括感染（17%）和恶性肿瘤（6%）。30天后，心血管疾病死亡降至34%（仅3%因心肌炎）。较高的死亡风险与年龄较大、查尔森合并症指数较高以及合并入住重症监护病房、心力衰竭、中风或心律失常的心肌炎有关。心肌炎患者面临着显著的死亡风险。最高死亡率发生在最初30天内，主要是由于心血管原因，尽管30天后主要死亡原因转向非心血管原因。
