Heart & Lung最新文献

{"title":"Ambulatory status and related factors in patients with spinal cord ischemia due to aortic aneurysm","authors":"","doi":"10.1016/j.hrtlng.2024.07.006","DOIUrl":"10.1016/j.hrtlng.2024.07.006","url":null,"abstract":"<div><h3>Background</h3><p>Spinal cord ischemia (SCI) is a serious complication that can occur at the onset of aortic aneurysm (AA) or after AA surgery. SCI impairs ambulation in patients. However, there is a lack of evidence regarding ambulatory status and its associated factors.</p></div><div><h3>Objectives</h3><p>To identify the ambulatory status of patients with SCI due to AA and/or AA surgery and sociodemographic and clinical characteristics factors associated with ambulatory status.</p></div><div><h3>Methods</h3><p>A descriptive study using a retrospective medical record data was undertaken. Data were collected from the electronic health records of SCI patients resulting from AA or who underwent surgical intervention for AA from January 2009 through December 2021. We analyzed the data to determine the ambulatory status before discharge. The demographic and clinical characteristics of the patients were investigated using chi-square and Fisher's exact tests to identify factors associated with ambulatory status.</p></div><div><h3>Results</h3><p>Among the 4,142 patients diagnosed with AA, 30 developed SCI. Of these 30 AA patients with SCI, 63.3 % were male. The median age was 70 years, ranging from 39 to 89 years. Six had SCI at the time of AA diagnosis. Among the subset of 2,994 patients who underwent aortic surgery, 24 developed SCI postoperatively. At discharge, two-thirds of the SCI patients with AA were unable to ambulate, and almost half were bedridden. The factors associated with ambulatory status were length of stay, neurogenic bladder, and pressure ulcers.</p></div><div><h3>Conclusions</h3><p>Most patients with SCI due to AA and/or AA surgery are unable to walk before discharge. Length of stay, neurogenic bladder, and pressure ulcers were associated with poor ambulatory status. Older adults and those with medical comorbidities and complications are at particularly high risk for impaired ambulation.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriateness and outcomes of hospitalized patients telemetry monitored for cardiac arrhythmias in accordance with the American Heart Association Practice Standards–A multicenter study","authors":"","doi":"10.1016/j.hrtlng.2024.07.005","DOIUrl":"10.1016/j.hrtlng.2024.07.005","url":null,"abstract":"<div><h3>Background</h3><p>To the best of our knowledge, no prospective research studies have compared clinical practice to the American Heart Association (AHA) updated practice standards for in-hospital telemetry monitoring.</p></div><div><h3>Objectives</h3><p>Our aims were therefore (1) to investigate how patients were assigned to telemetry monitoring in accordance with the AHA's updated practice standards, (2) to determine the number and type of arrhythmic events, and (3) to describe subsequent changes in clinical management.</p></div><div><h3>Methods</h3><p>This prospective multicenter study included 1154 patients at three university hospitals in Norway. Data were collected 24/7 over a four-week period, with follow-up measurements from telemetry admission until hospital discharge.</p></div><div><h3>Results</h3><p>Of patients assigned to telemetry, 67 % (<em>n</em> = 767) met practice standards, corresponding to AHA Class I or II. Patients were predominantly men (65 %, <em>n</em> = 748), and the mean age was 65 years (SD ±16). The study included both patients with cardiac and non-cardiac diagnoses from various medical and surgical departments throughout the hospitals. Ninety-one percent of the patients in Class III were monitored based on indications that were reclassified from Class II to Class III (not indicated) in the updated practice standards (patients admitted with chest pain or post-percutaneous coronary intervention (PCI) without complications). Overall, arrhythmic events occurred in 37 % (<em>n</em> = 424) of patients, and they occurred in all classes. Eighteen percent (<em>n</em> = 59) of arrhythmic events occurred in Class III. Of all arrhythmias, 3 % (<em>n</em> = 14) were life threatening, and all of them occurring within Class I. Telemetry monitoring led to changes in clinical management in 22 % (<em>n</em> = 257) of patients due to clinical alarms, of which 71 % (<em>n</em> = 182) were related to medication management.</p></div><div><h3>Conclusions</h3><p>Most patients were appropriately monitored according to the AHA practice standards, meeting Class I and II. Arrhythmias occurred in all classes, but life-threatening arrhythmias only occurred in patients in Class I. However, a daily re-assessment of each patient's telemetry indication is warranted.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S014795632400133X/pdfft?md5=b5abf060d4e398207cb09a8157a7e5d3&pid=1-s2.0-S014795632400133X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of vigorous physical exertion on cardiac demand under conditions of daily living among firefighters with elevated blood pressure","authors":"","doi":"10.1016/j.hrtlng.2024.07.008","DOIUrl":"10.1016/j.hrtlng.2024.07.008","url":null,"abstract":"<div><h3>Background</h3><p>Firefighters have a high prevalence of cardiovascular disease. The poor heart health of firefighters is implicated in their increased risk of sudden cardiac death (SCD). Exercise may be protective against SCD partially due to the immediate blood pressure (BP) reductions of 5–8 mmHg following exercise, termed <em>postexercise hypotension</em> (PEH)</p></div><div><h3>Objectives</h3><p>To examine PEH under ambulatory conditions after a maximal cardiopulmonary exercise test (CPET) among career firefighters</p></div><div><h3>Methods</h3><p>Firefighters (<em>n</em> = 19) completed a maximal CPET and non-exercise control (CONTROL) in random order on separate non-workdays and left the laboratory instrumented to an ambulatory BP (ABP) monitor. Ambulatory systolic BP (ASBP), diastolic BP (ADBP), and heart rate (AHR) were recorded at hourly intervals over 19hr. The ambulatory rate pressure product (ARPP) was calculated as ASBPxAHRx10^–3 at each hourly interval. Repeated measures ANCOVA tested if the ABP, AHR, and ARPP responses differed after CPET vs CONTROL over 19hr</p></div><div><h3>Results</h3><p>Firefighters were middle-aged (39.5 ± 8.9 yr), overweight (29.2 ± 4.0 kg/m²) men with elevated BP (123.1 ± 9.6/79.8 ± 10.4 mmHg), while resting HR (67.7 ± 11.3 bpm) and RPP (8.4 ± 1.7mmHg*bpm*10^–3) were in normal ranges. ASBP (16.6 ± 5.7 mmHg) and ADBP (3.1 ± 4.6 mmHg) increased after the CPET vs CONTROL over 19hr (ps&lt;0.01), as did AHR (9.4 ± 7.9 bpm, <em>p</em> = 0.02) and ARPP (2.5 ± 1.1mmHg*bpm*10^–3, <em>p</em> &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>Unexpectedly, the firefighters exhibited <em>postexercise hypertension</em> rather than PEH. The increases in ABP and AHR we observed indicated a sustained increase in cardiac demand. Further investigation is needed to confirm our findings and determine whether the adverse hemodynamic responses we observed contribute to the high prevalence of SCD that firefighters experience on the job.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of staged autologous blood transfusion during extracorporeal membrane oxygenation decannulation: A retrospective study","authors":"","doi":"10.1016/j.hrtlng.2024.07.009","DOIUrl":"10.1016/j.hrtlng.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><p>Clinical blood resources are scarce and autologous blood transfusion for extracorporeal membrane oxygenation (ECMO) withdrawal is less studied.</p></div><div><h3>Objectives</h3><p>To assess the use of staged autotransfusion during ECMO decannulation.</p></div><div><h3>Methods</h3><p>The study included ECMO withdrawal patients. Patients in the autologous transfusion group underwent staged transfusion during ECMO withdrawal, while those in the control group received 2.0 units of allogeneic packed red blood cells (RBCs) to increase hemoglobin (Hb). Parameters such as Hb, hematocrit (Hct), adverse events, decannulation success rate, volume of allogeneic RBC transfusions, and transfusion costs were compared.</p></div><div><h3>Results</h3><p>A total of 82 Chinese patients were enrolled, with a mean age of 46 years, 27 were female, and the top three primary diagnoses were cardiac arrest, acute myocarditis, and severe pneumonia. There were 41 individuals in the autologous blood transfusion group and 41 in the control group. No significant differences were observed in Hb, Hct, adverse events, and the success rate for decannulation between the two groups (all <em>P</em> &gt; 0.05). Compared with the control group, the volume of allogeneic RBC transfusions [0 (0∼1.50) U vs. 3.5 (1.88∼40) U, <em>P</em> &lt; 0.001] and the total cost [130 (130∼390) Chinese Yuan (CNY) vs. 910 (487.50, 1040) CNY, <em>P</em> = 0.002] were lower in the autologous transfusion group.</p></div><div><h3>Conclusion</h3><p>In comparison with allogeneic RBC transfusion, staged autotransfusion during ECMO decannulation not only effectively maintained Hb levels but also reduced the requirement for allogeneic RBC transfusions. In addition, this approach decreased the associated costs and did not increase the risk of clinical adverse events.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001365/pdfft?md5=8f5a1e0161368b525b44fefdc95d25dc&pid=1-s2.0-S0147956324001365-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for readmission after sepsis and its association with mortality","authors":"","doi":"10.1016/j.hrtlng.2024.07.007","DOIUrl":"10.1016/j.hrtlng.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><p>Sepsis is associated with an approximately 20 % 30-day readmission rate and with subsequent mortality.</p></div><div><h3>Objectives</h3><p>To determine the demographics, comorbidities that had been documented prior to sepsis onset, processes of care, commonly administered laboratory tests measured near discharge, and post-sepsis infections that may be associated with readmission and, secondarily, whether readmission is an independent risk factor for 90-day mortality.</p></div><div><h3>Methods</h3><p>Using a database of patients who met Sepsis-3 criteria divided into Construction and Validation groups, we used logistic regression to estimate the factors independently associated with readmission within 30 days after discharge and proportional hazard regression to estimate the factors independently associated with 90-day mortality.</p></div><div><h3>Results</h3><p>Of the 30,798 patients ≥ 18 years at our combined referral and community hospital and were discharged alive who met Sepsis-3 criteria between July 10, 2009 and September 7, 2019, 5943 (19 %) were readmitted within 30 days. Thirteen thousand, four hundred forty-four (44 %) of the patients were female, 25,293 (82 %) White, 3523 (11 %) Black, and the mean age was 59 ± 17 years. Among the readmitted patients, 894 (15 %) died within 90 days from the original discharge compared to 11 % (<em>p</em> &lt; 0.001) who had not been readmitted. Seven comorbidities, five processes of care (presepsis platelet transfusion, postsepsis platelet transfusion, operation, ICU length of stay, and hospital length of stay), five culture results, two discharge laboratory values, and discharge location were associated with readmission. The model had good discrimination, 0.770 ± 0.004 (Construction Group) and 0.748 ± 0.006 (Validation Group) and good relevancy (area under the precision recall curve), 0.390 ± 0.004 (Construction group) and 0.476 ± 0.005 (Validation group). Readmission within 30 days was independently associated with a 56 % higher risk of death (HR=1.562, 95 % CI=1.434, 1.703, <em>p</em> &lt; 0.001) within 90 days from discharge.</p></div><div><h3>Conclusions</h3><p>Comorbidities, abnormal laboratory values, processes of care, and post-sepsis onset culture results, but not demographic characteristics, were associated with 30-day readmission. Readmission was associated with 90-day mortality.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141729735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Sodium-Glucose Transporter-2 Inhibitors (SGLT-2i) in preventing chronic obstructive disease exacerbation in patients with diabetes and COPD: An electronic health database analysis","authors":"","doi":"10.1016/j.hrtlng.2024.07.003","DOIUrl":"10.1016/j.hrtlng.2024.07.003","url":null,"abstract":"<div><h3>Background</h3><p>Sodium Glucose Transporter 2 inhibitor (SGLT-2i) medications reduce inflammation, improve glycemic control, and impart weight loss, all of which may play a role in chronic obstructive pulmonary disease (COPD) pathophysiology.</p></div><div><h3>Objectives</h3><p>The primary objective of our study was to explore the incidence of COPD exacerbation in patients with diabetes and COPD on SGLT-2i medications. The secondary objective was to assess the impact of SGLT-2i medications on COPD exacerbations needing hospitalization, ICU admission, and mechanical ventilation.</p></div><div><h3>Methods</h3><p>This was a retrospective cohort analysis of COPD patients with diabetes enrolled in the COPD registry at a Mid-west Tertiary care teaching hospital from January 1, 2022, to December 31, 2022. We used Slicer-Dicer, a self-service cohort exploration tool embedded in EPIC for data extraction.</p></div><div><h3>Results</h3><p>We had 31,411 patients registered with the COPD registry during the study period. Of these, 18,713 had diabetes, and 1295 patients were on SGLT-2i medication. The incidence of COPD exacerbation, including severe COPD exacerbation needing hospitalization, was significantly lower in the SGLT-2i medication group (3.16% vs 18.3%, <em>p</em> &lt; 0.05; 1.2% vs 5.04%, <em>p</em> &lt; 0.05). Also, there was a non-significant trend suggesting that the incidence of COPD exacerbation needing intensive care unit admission and intubation was lower in the SGLT-2i medication group (0.07% vs 3.4%; 0 vs 0.04%). SGLT-2i medication use was associated with reduced incidence of COPD exacerbation irrespective of underlying control of diabetes.</p></div><div><h3>Conclusions</h3><p>Our study suggests possible role of SGLT-2i in preventing COPD exacerbation. Randomized trials are needed in the future to confirm or refute these findings.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication intervention for families in adult intensive care units during COVID-19 pandemic: A systematic review","authors":"","doi":"10.1016/j.hrtlng.2024.07.004","DOIUrl":"10.1016/j.hrtlng.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><p>Restrictions on ICU family visitation during COVID-19 pandemic posed communication challenges for families, patients, and healthcare teams. Diverse approaches were used to overcome communication barriers. As ICUs begin to reinstate family visitation, it is timely to review the lessons learned from these interventions during the pandemic.</p></div><div><h3>Objectives</h3><p>To identify and evaluate content and qualities of the studies that describe communication interventions for families of adult ICU patients during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>Following the PRISMA guidelines, we searched PubMed, Embase, CINAHL, and Web of Science for studies that (1) involved communication intervention for families in adult ICU settings, (2) were published between January 2020 and September 2022, and (3) were published in English. We excluded studies that were not from peer-reviewed journal articles or in English.</p></div><div><h3>Results</h3><p>Of 2,628 articles initially identified, we reviewed the 23 selected studies (20 non-experimental and 3 experimental studies). Most of the studies were published in 2022 (<em>n</em> = 14, 60.9 %) and conducted in Europe (<em>n</em> = 13, 56.5 %). Various communication methods (e.g., video calls, telephone, applications) were used to provide information, emotional support, and virtual access to patients and their families. Video calls were the most frequently used intervention. Many interventions included healthcare teams providing updates on the patient's condition or treatment to the family.</p></div><div><h3>Conclusions</h3><p>The COVID-19 pandemic prompted the adoption of diverse communication approaches for families in ICU settings, despite many limitations, including technical challenges. Insights gained from this experience will help expedite flexibility and diversity in designing communication interventions for ICU family members.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight-adjusted waist index is an independent predictor of all-cause and cause-specific mortality in patients with asthma","authors":"Shidong Wang ,&nbsp;Dai Li ,&nbsp;Liping Sun","doi":"10.1016/j.hrtlng.2024.07.002","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.07.002","url":null,"abstract":"<div><h3>Background</h3><p>There is a close relationship between obesity and the occurrence of asthma.The weight-adjusted waist index (WWI) is a relatively novel anthropometric parameter that reflects obesity.</p></div><div><h3>Objective</h3><p>We aimed to explore the association between WWI and mortality in the asthma population.</p></div><div><h3>Methods</h3><p>We included adult with asthma from NHANES 1999–2018. WWI = Waist circumference (cm)/square root of body weight (kg). Current asthma was determined by the participant's responses in standardized questionnaires. All-cause, cardiovascular disease (CVD), cancer, and respiratory disease mortality information was obtained by prospectively matching these data to the National Death Index. Multivariate-adjusted Cox proportional hazards regression analyses, Kaplan Meier survival analyses, restricted cubic spline (RCS) analyses, stratified analyses, and sensitivity analyses were used to clarify these associations.</p></div><div><h3>Results</h3><p>A total of 101,316 participants were included in the study, and 3223 were diagnosed with asthma.WWI was independently and positively associated with all-cause and all factor-specific mortality in asthma. In fully adjusted models, each unit increase in WWI was associated with 43 % (hazard ratio [HR] and 95 % confidence interval [CI] = 1.43 [1.25,1.64], <em>p</em> &lt; 0.0001), 58 % (1.58 [1.25, 1.99], <em>p</em> &lt; 0.001), 50 % (1.50 [1.19, 1.90], <em>p</em> &lt; 0.001), and 79 % (1.79 [1.34, 2.39], <em>p</em> &lt; 0.0001) increased all-cause, CVD, cancer, and respiratory disease mortality, respectively. RCS analyses showed largely linear associations between WWI and all mortality risks. Stratified analyses indicated that these associations were influenced by multiple factors, and that age was consistently the effect modifier across all associations.</p></div><div><h3>Conclusions</h3><p>WWI is an independent predictor of all-cause, CVD, cancer, and respiratory-related mortality in the adult asthma population. These findings highlight that WWI may have novel prognostic value as a simple and easily accessible obesity parameter in asthma patients.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001304/pdfft?md5=5770841dbe3d791cb8c7312877be1328&pid=1-s2.0-S0147956324001304-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on mechanical ventilation cases and mortality rates in non-SARS-CoV-2 patients: A nationwide analysis in Spain","authors":"Javier Muñoz MDPhD","doi":"10.1016/j.hrtlng.2024.06.017","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.06.017","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic has presented unprecedented challenges for healthcare systems globally, impacting critical care resources and patient outcomes. Understanding its multifaceted effects is crucial for future crisis response.</p></div><div><h3>Objective</h3><p>Analyze the repercussions of the COVID-19 pandemic on mechanical ventilation cases and mortality among non-SARS-CoV-2 patients.</p></div><div><h3>Methods</h3><p>A nationwide database encompassing all patients receiving mechanical ventilation in Spain was used to compare the number of cases and clinical outcomes during COVID-19 (March 2020 - December 2021) to pre-pandemic cases (May 2018 - February 2020). Univariate and multivariate analyses were employed.</p></div><div><h3>Results</h3><p>COVID-19 significantly reduced access to ventilation for non-COVID-19 patients. A 16 % decrease (12,099 fewer patients) was observed during the pandemic compared to pre-pandemic times. This reduction affected all analyzed conditions except self-inflicted injuries, coinciding with a rise in overall mortality risk (34.5% vs 35.6 %, OR 1.09, 95 %CI 1.06–1.12). The increased mortality was consistent across diverse admission types, including cancer (37.1% vs. 41.5 %, OR 1.18, 95 %CI 1.09–1.29), hemorrhagic strokes (55.4% vs. 56.6 %, OR 1.07, 95 %CI 1.02–1.20), acute myocardial infarction (35.6% vs. 38 %, OR 1.11, 95 %CI 1.01–1.21), non-SARS-CoV-2 pneumonia (44.5% vs. 45.8 %, OR 1.12, 95 %CI 1.02–1.24), septic shock (54.7% vs. 56.3 %, OR 1.10, 95 %CI 1.06–1.15), and prolonged ventilation (≥96 h) (37% vs. 38.2 %, OR 1.10, 95 %CI 1.06–1.10).</p></div><div><h3>Conclusions</h3><p>The findings underscore the profound impact of the COVID-19 pandemic on critical care utilization and patient outcomes among non-SARS-CoV-2 patients. As healthcare systems strive to mitigate future crises, these insights emphasize adaptable strategies for equitable access to life-saving treatments.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient mortality and outcomes of COVID-19 among patients with non-ischemic cardiomyopathy: A propensity matched analysis.","authors":"Mirza Faris Ali Baig, Kalyan Chaliki","doi":"10.1016/j.hrtlng.2024.06.018","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.06.018","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic medical conditions, particularly cardiovascular diseases, are at a greater risk of adverse outcomes due to COVID-19. The effect of COVID-19 on patients with non-ischemic cardiomyopathy (NICM) is not known well.</p><p><strong>Objectives: </strong>To study the impact of COVID-19 infection on NICM hospital mortality and other outcomes.</p><p><strong>Methods: </strong>This study included a cohort of patients from the 2020 and 2021 National Inpatient Sample databases. Patients hospitalized for COVID-19 with and without NICM were matched using a 1:1 propensity score-matching ratio. Outcomes analyzed were in-hospital mortality, rates of acute kidney injury (AKI), acute myocardial infarction (AMI), cardiogenic shock, cardiac arrest, mechanical ventilation, tracheal intubation, pulmonary embolism (PE), ventricular tachycardia (VT), ventricular fibrillation (VF), length of stay (LOS), and total hospitalization charges.</p><p><strong>Results: </strong>A total of 2,532,652 patients met the inclusion criteria (1,199,008 females [47.3 %], predominantly white 1,456,203 (57.5 %); mean [SD] age 63 [5.4] years), including 64,155 (2.5 %) patients with a history of NICM. Following propensity matching, 10,258 COVID-19 patients with and without NICM were matched. Patients with NICM had higher rates of AMI (11.1 vs. 7.1 %, p < 0.001), cardiogenic shock (2 vs. 0.6 %, p < 0.001), cardiac arrest (4.4 vs. 3.2 %, p < 0.01), mechanical ventilation (13.7 vs 12 %, p < 0.01), VT (8.5 vs. 2.2 %, p < 0.001), and VF (1.0 vs 0.25 %, p < 0.001). The odds ratios for in-hospital mortality, AKI, and PE did not differ significantly.</p><p><strong>Conclusion: </strong>A History of NICM does not affect COVID-19 mortality but increases the risk of cardiovascular complications.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}