Conduction Abnormalities: Types, Associated Factors and their Effect on Clinical Outcomes of Patients Admitted to the Coronary Care Unit at King Abdulaziz University Hospital

Abstract

Background: Since conduction abnormalities represent a major cause of sudden death and cardiovascular complications, with a high incidence of increased length of hospital stay, risk of disabilities and healthcare costs, the aim was to discern the influence of conduction abnormalities at the time of admission on the clinical outcomes of patients admitted at the Coronary Care Unit in King Abdulaziz University Hospital. Method: The study adopted a retrospective-record review, episode-based design for a period of 2 years. All patients with sustained conduction abnormalities at the time of admission that had either self-terminated or required intervention were recruited. Statistical analysis was conducted by SPSS. Results:  A total of 1763 admissions occurred during the study period, conduction abnormalities represented 11.5% of all these cases. The most common types were left bundle branch block and atrial fibrillation. Types that were significantly associated with the length of stay were atrial fibrillation (p = 0.045), ventricular tachycardia (p = 0.020), and ventricular fibrillation (p = 0.007) and complete heart block (p = 0.004). Right bundle branch block was the only conduction abnormality that was significantly associated with higher mortality (p = 0.011). Conclusion:  Patients with right bundle branch block need close monitoring and optimal care to reduce risks of increased hospital stay and death. Further, it is imperative that attention should be directed in general to all patients admitted to the Coronary Care Unit with any kind of conduction abnormality in order to attempt to reduce their stay.