急性呼吸困难住院患者胸痛、诊断和临床结果之间的关系:来自 ACE 2 研究的数据。

IF 1.9 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiology Pub Date : 2024-10-16 DOI:10.1159/000541897
Rahul Bhatnagar, Kristian Berge, Arne Didrik Høiseth, Torbjørn Omland, Magnus Nakrem Lyngbakken, Helge Røsjø
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引用次数: 0

摘要

简介:因呼吸困难住院的患者有时也会报告并发胸痛。急性呼吸困难患者并发胸痛是否与具体诊断和临床结果有关,目前尚不清楚:我们纳入了 313 名因急性呼吸困难入住阿克苏斯大学医院的患者,并在患者入院时直接询问他们在过去 24 小时内是否经历过胸痛。急性呼吸困难的急性心力衰竭(HF)或非 HF 病因的急性呼吸困难诊断由两名专家独立完成。非心衰患者则进一步分为慢性阻塞性肺病(COPD)或非慢性阻塞性肺病病因:共有 143 名急性心房颤动患者(占总人数的 46%)、83 名慢性阻塞性肺疾病患者(占总人数的 26%)和 87 名非心房颤动、非慢性阻塞性肺疾病相关的呼吸困难患者(占总人数的 28%)入院。96名急性呼吸困难患者(31%)报告在入院前的24小时内出现过胸痛。因急性高血压(42 人,44%)、慢性阻塞性肺疾病急性加重(22 人,23%)或非高血压、非慢性阻塞性肺疾病相关呼吸困难(32 人,33%)而住院的患者,其胸痛发生率无统计学差异,组间所有比较的 p>0.05 为差异。在中位数为 823 天的随访期间,114 名患者死亡(36%)。与呼吸困难且无胸痛的患者相比,呼吸困难且伴有胸痛的患者的预后没有差异(log-rank 检验:P=0.09)。入院前的胸痛与任何裁定诊断组的全因死亡率均无关联:31%的急性呼吸困难住院患者有胸痛报告,但胸痛发生率并不因诊断结果而异。有呼吸困难和胸痛的患者与无呼吸困难和胸痛的患者相比,预后并不差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Associations between Chest Pain, Diagnosis, and Clinical Outcome in Patients Hospitalized with Acute Dyspnea: Data from the ACE 2 Study.

Introduction: Patients hospitalized due to dyspnea sometimes also report concomitant chest pain. Whether co-existing chest pain in patients with acute dyspnea associates with specific diagnosis and clinical outcome is not known.

Method: We included 313 patients admitted to Akershus University Hospital with acute dyspnea and asked the patients directly on hospital admission whether they had experienced chest pain during the last 24 h. We examined the associations between chest pain and (1) diagnosis of the index hospitalization and (2) clinical outcome during follow-up. The diagnosis for the index hospitalization was adjudicated as acute heart failure (HF) or non-HF etiology of acute dyspnea by two experts working independently. Non-HF patients were further sub-grouped into chronic obstructive pulmonary disease (COPD) or non-COPD etiology.

Results: In total, 143 patients were admitted with acute HF (46% of the population), 83 patients with COPD (26% of the population), and 87 patients with non-HF, non-COPD-related dyspnea (28% of the population). Ninety-six patients (31%) with acute dyspnea reported chest pain during the last 24 h prior to hospital admission. The prevalence of chest pain was not statistically different for patients who were hospitalized with acute HF (n = 42, 44%), acute exacerbation of COPD (n = 22, 23%), or non-HF, non-COPD-related dyspnea (n = 32, 33%), p > 0.05 for all comparisons between groups. During median of 823 days follow-up, 114 patients died (36%). Patients with dyspnea and concomitant chest pain did not have different outcome compared to patients with dyspnea and no chest pain (log-rank test: p = 0.09). Chest pain prior to admission was neither associated with all-cause mortality in any of the adjudicated diagnosis groups.

Conclusions: Chest pain was reported in 31% of patients hospitalized with acute dyspnea but the prevalence did not differ according to adjudicated diagnosis. Patients with dyspnea and chest pain did not have worse outcome compared to patients with dyspnea and no chest pain.

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来源期刊
Cardiology
Cardiology 医学-心血管系统
CiteScore
3.40
自引率
5.30%
发文量
56
审稿时长
1.5 months
期刊介绍: ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.
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