心房是否会在患有败血症或心脏冲击的患者中恶化预后?
Tobias Schupp1, Jan Forner1, Jonas Rusnak1
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany; European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany.
The American journal of cardiology
|August 20, 2023
概括
在患有败血症或心脏性休克的重症患者中,心房动 (AF) 不影响30天死亡率. 然而,心脏性休克的AF患者的快速心室率增加了死亡风险.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 电子生理学 电子生理学
背景情况:
- 在许多疾病中,心房动 (AF) 与较高的死亡率有关.
- 在患有败血症或心脏性休克的重症患者中,AF的预后意义尚未得到充分确立.
研究的目的:
- 调查先前存在的和新发病的AF对患有败血症或心脏性休克的患者30天全因死亡率的预后影响.
主要方法:
- 预期将败血症,败血症或心脏性休克患者纳入单一中心注册表 (2019-2021年).
- 统计分析包括卡普兰-梅尔,多变量物流和考克斯比例回归.
- 评估了644名患者 (273名心脏性休克,361名败血症/败血性休克).
主要成果:
- 肌前膜炎的患病率为41% (29%是先前存在的,12%是新发病的).
- 在整体队列中,既没有先前存在的,也没有新出现的AF与30天死亡率有关.
- 在心脏性休克患者中,腹腔动脉率>120 bpm增加了死亡风险 (HR 1.886,p=0.010).
- 增加的年龄是新发性AF的唯一预测因素 (OR 1.042,p=0.001).
结论:
- 预先存在的和新出现的AF似乎不会影响心脏病性休克严重患者的30天死亡率.
- 对于心脏发生性休克的AF患者来说,心室频率控制至关重要.
- 在这个人群中,年龄是发展新发性AF的重要预测因素.
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