接受老年综合护理的老年人中的心律失常:患病率及相关因素

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Marco Meyer, Andreas Arnold, T. Stein, U. Niemöller, Christian Tanislav, D. Erkapic
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引用次数: 0

摘要

背景:心血管疾病和心律失常是随着年龄增长而增加的病症,与严重的发病率和死亡率相关。本研究旨在调查接受老年病综合治疗(CGC)的老年人群体中心律失常的患病率及其临床关联。方法:对住院接受老年综合护理的老年患者的 Holter 心电图监测(HECG)进行分析。研究了心律失常的发病率以及心律失常的存在、患者特征和日常生活基本活动(通过巴特尔指数(BI)评估)、行走能力(通过定时起立行走测试(TUG)评估)以及平衡和步态(通过蒂内蒂平衡和步态测试(TBGT)评估)的功能状态之间的关联。研究结果本研究共纳入 626 名患者(平均年龄:83.9 ± 6.6 岁,67.7% 为女性)。在 HECG 中发现的最常见心律失常是室性早搏(87.2%)、房性早搏(71.7%)和心房颤动(22.7%)。心房扑动占 1.0%,阵发性室上性心动过速占 5.8%,非持续性室性心动过速占 12.5%,一度房室传导阻滞占 0.8%,二度房室传导阻滞 Mobitz I 型占 0.8%,二度房室传导阻滞 Mobitz II 型占 0.3%,任何原因导致的停顿 > 2.5 秒占 3.5%,任何原因导致的停顿 > 3 秒占 1.6%。房性早搏与女性性别有关(74.8% 对 65.3%,P = 0.018),而在男性患者中,以下心律失常更为常见:室性早搏(91.6% 对 85.1%,P = 0.029)、室性期前收缩(8.4% 对 3.8%,P = 0.021)和非持续性室速(17.3% 对 10.1%,P = 0.014)。无法行走的患者(TUG 得分为 5 分)与基本独立行动的患者(TUG 得分为 1 分或 2 分)相比,室性早搏在无法行走的患者(TUG 得分为 5 分)中更为常见(88.0% 对 75.0%,P = 0.023)。在逻辑回归分析中,HECG 检测到的心房颤动被确定为跌倒风险高的风险因素(几率比(OR):2.35,95% 置信区间(CI):1.23-4.46)。结论在我们的研究中,对因患 CGC 而住院的老年人进行的 HECG 调查显示,房性早搏、室性早搏和心房颤动是最常见的心律失常。研究发现,房性早搏在女性患者中更为常见,而男性患者则更容易发生室性早搏。在接受调查的人群中,心房颤动是一个与高跌倒风险相关的风险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Arrhythmias among Older Adults Receiving Comprehensive Geriatric Care: Prevalence and Associated Factors
Background: Cardiovascular diseases and arrhythmias are medical conditions that increase with age and are associated with significant morbidities and mortality. The aim of the present study was to investigate the prevalence of arrhythmias and clinical associations in the collective of older adults receiving comprehensive geriatric care (CGC). Methods: Holter ECG monitoring (HECG) of older patients hospitalized for CGC was analyzed. The prevalence of arrhythmias and the associations between the presence of arrhythmias, patients’ characteristics and the functional status regarding basic activities of daily living (assessed by the Barthel index (BI)), walking ability (assessed by the timed up and go test (TUG)), and balance and gait (assessed by the Tinetti balance and gait test (TBGT)) were examined. Results: In the presented study, 626 patients were included (mean age: 83.9 ± 6.6 years, 67.7% were female). The most common arrhythmias detected in HECG were premature ventricular contractions (87.2%), premature atrial contractions (71.7%), and atrial fibrillation (22.7%). Atrial flutter was found in 1.0%, paroxysmal supraventricular tachycardia in 5.8%, non-sustained ventricular tachycardia in 12.5%, first-degree AV block in 0.8%, second-degree AV block type Mobitz I in 0.8%, second-degree AV block type Mobitz II in 0.3%, pause > 2.5 s any cause in 3.5%, and pause > 3 s any cause in 1.6% of the cases. Premature atrial contractions were associated with the female sex (74.8% vs. 65.3%, p = 0.018), whereas in male patients, the following arrhythmias were more common: premature ventricular contractions (91.6% vs. 85.1%, p = 0.029), ventricular bigeminus (8.4% vs. 3.8%, p = 0.021), and non-sustained ventricular tachycardia (17.3% vs. 10.1%, p = 0.014). Atrial fibrillation detected in HECG was more frequent in patients at high risk of falls, indicated by their TBGT score ≤ 18 (24.7% vs. 12.0%, p = 0.006), and premature ventricular contractions were more common in patients unable to walk (TUG score 5) compared to those with largely independent mobility (TUG score 1 or 2) (88.0% vs. 75.0%, p = 0.023). In a logistic regression analysis, atrial fibrillation detected in HECG was identified as a risk factor for a high risk of falls (odds ratio (OR): 2.35, 95% confidence interval (CI): 1.23–4.46). Conclusion: In our study, investigation of HECG of older adults hospitalized for CGC revealed that premature atrial contractions, premature ventricular contractions, and atrial fibrillation were the most common arrhythmias. Premature atrial contractions were found to be more frequent in female patients, while male patients were more prone to premature ventricular contractions. In the investigated population, atrial fibrillation emerged as a risk factor associated with a high risk of falls.
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来源期刊
Clinics and Practice
Clinics and Practice MEDICINE, GENERAL & INTERNAL-
CiteScore
2.60
自引率
4.30%
发文量
91
审稿时长
10 weeks
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