Analysis of risk factors for adverse cardiac events in adults with acute myocarditis during hospitalization

Q4 Nursing

中华急诊医学杂志 Pub Date : 2019-07-10 DOI:10.3760/CMA.J.ISSN.1671-0282.2019.07.007

Han Zhao, Wen-Xian Liu, Yanlong Ren, Shangqiu Ning

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Abstract

Objective To analyze the risk factors of adverse cardiac events in adults with acute myocarditis during hospitalization and provide reference for clinical diagnosis and treatment. Methods A restrospective study was conducted in 80 patients (54 males and 26 females) with acute myocarditis over 18 years old admitted to our hospital between January 2007 and December 2016. Major adverse cardiac events (MACE) were defined as death, cardiac arrest, cardiogenic shock and ventricular fibrillation. According to whether MACE occurred during hospitalization, patients were divided into two groups: the MACE group and the non-MACE group. The differences between the two groups were compared, and the risk factors were analyzed by logistic regression. Results There were 12 patients in the MACE group and 68 patients in the non-MACE group. The age of patients in the two groups was similar. Compared with the non-MACE group, the proportion of female patient in the MACE group was higher (66.7% vs 26.5%, P=0.015), and the systolic pressure (mmHg) was lower at admission (89.75±17.63 vs 112.49±16.35, P 120 ms) was significantly higher in the MACE group (75% vs 17.6%, P<0.01). In the MACE group, the proportion of diuretics and vasoactive drugs (dopamine, norepinephrine, and adrenaline) was higher (66.7% vs 25%, 91.7% vs 4.4%,66.7% vs 0,75% vs 0%, all P<0.01); the proportion of glucocorticoids and immunoglobulin was higher (33.3% vs 8.8%, P=0.038; 33.3% vs 4.4%, P=0.008), and the proportion of ventilator, CRRT, ECMO and IABP were also higher (50% vs 1.5%, 33.3% vs 0, 25% vs 0%, 25% vs 0%, all P<0.01). Logistic regression analysis showed that the OR value of MACE in female patients during hospitalization was 5.56 (95%CI: 1.49-20.71, P=0.011). The OR value of MACE in patients with reduced LVEF at admission was 5.92 (95%CI: 1.62-21.67, P=0.007).The OR value of MACE in patients with prolonged QRS wave was 14.00 (95%CI: 3.29-59.55, P<0.01). Conclusions Female patients, LVEF 120 ms) are independent risk factors for MACE in adult patients with acute myocarditis during hospitalization. Key words: Acute myocarditis; Adult; Major adverse cardiac events; Risk factors

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急性心肌炎住院期间成人不良心脏事件的危险因素分析

目的分析成人急性心肌炎住院期间发生心脏不良事件的危险因素，为临床诊断和治疗提供参考。方法对2007年1月至2016年12月我院收治的80例18岁以上急性心肌炎患者(男54例，女26例)进行回顾性分析。主要心脏不良事件(MACE)定义为死亡、心脏骤停、心源性休克和心室颤动。根据住院期间是否发生MACE，将患者分为MACE组和非MACE组。比较两组间的差异，并对危险因素进行logistic回归分析。结果MACE组12例，非MACE组68例。两组患者年龄相近。与非MACE组相比，MACE组女性患者比例较高(66.7% vs 26.5%， P=0.015)，入院时收缩压(mmHg)较低(89.75±17.63 vs 112.49±16.35,P= 120ms)， MACE组显著高于非MACE组(75% vs 17.6%， P<0.01)。MACE组利尿剂和血管活性药物(多巴胺、去甲肾上腺素、肾上腺素)使用比例分别为66.7%比25%、91.7%比4.4%、66.7%比0%、75%比0%，P均<0.01);糖皮质激素和免疫球蛋白比例较高(33.3% vs 8.8%， P=0.038;33.3% vs 4.4%， P=0.008)，呼吸机、CRRT、ECMO和IABP的比例也较高(50% vs 1.5%， 33.3% vs 0, 25% vs 0%， 25% vs 0%， P均<0.01)。Logistic回归分析显示，女性患者住院期间MACE OR值为5.56 (95%CI: 1.49 ~ 20.71, P=0.011)。入院时LVEF降低患者的MACE OR值为5.92 (95%CI: 1.62 ~ 21.67, P=0.007)。QRS波延长患者MACE的OR值为14.00 (95%CI: 3.29 ~ 59.55, P<0.01)。结论女性患者(LVEF 120 ms)是成年急性心肌炎患者住院期间发生MACE的独立危险因素。关键词:急性心肌炎;成年人;主要心脏不良事件;风险因素

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来源期刊

中华急诊医学杂志 Nursing-Emergency Nursing

CiteScore

0.10

自引率

0.00%

发文量

8629

期刊介绍： Chinese Journal of Emergency Medicine is the only national journal which represents the development of emergency medicine in China. The journal is supervised by China Association of Science and Technology, sponsored by Chinese Medical Association, and co-sponsored by Zhejiang University. The journal publishes original research articles dealing with all aspects of clinical practice and research in emergency medicine. The columns include Pre-Hospital Rescue, Emergency Care, Trauma, Resuscitation, Poisoning, Disaster Medicine, Continuing Education, etc. It has a wide coverage in China, and builds up communication with Hong Kong, Macao, Taiwan and international emergency medicine circles.