比较 Takotsubo 心肌病和慢性阻塞性肺病患者的院内预后。

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2024-11-20 DOI:10.1016/j.hrtlng.2024.11.008

Chenlin Li MD , Pengyang Li MD , Xiaojia Lu MD , Yan Chen MD , Peng Cai MD , Catherine Teng MD , Jie Jing MS , Jingkun Zhang MD , Shiyan Jiang MD , Yue Liu MD , Jing Liang MD , Yanxuan Wang MD , Bin Wang MD, PhD

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引用次数: 0

摘要

背景：继发性Takotsubo综合征（TTS）在临床特征、管理和预后方面与原发性TTS不同。慢性阻塞性肺病（COPD）加重已被认为是 TTS 的生理诱因，但其对继发性 TTS 预后的影响却鲜为人知：本研究旨在探讨 COPD 对 TTS 患者院内预后的影响：方法：利用全国住院病人抽样调查的数据，确定了主要诊断为慢性阻塞性肺病且继发诊断为 TTS 的患者（慢性阻塞性肺病-TTS 组）。对照组（TTS-COPD 组）则选择主要诊断为 TTS 并合并 COPD 的患者。然后，我们比较了倾向得分匹配前后的院内死亡率和不良事件发生率：结果：经过匹配后，TTS-COPD 组和 COPD-TTS 组各有 603 名患者。两组患者的平均年龄约为 68 岁，85% 以上为女性。两组患者的院内死亡率或心脏骤停、室性心律失常和 AKI 发生率在统计学上无明显差异（所有组别，P > 0.05）。与TTS-COPD患者相比，COPD-TTS患者的急性呼吸衰竭（ARF）发生率更高（P < 0.001），心源性休克发生率更低（P = 0.001），住院时间更长（LOS）（P < 0.001）：结论：与TTS-COPD患者相比，COPD-TTS患者发生ARF的比例更高，住院时间更长，但发生心源性休克的风险更低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Comparing the in-hospital outcomes of patients with Takotsubo cardiomyopathy and chronic obstructive pulmonary disease

Background

Secondary Takotsubo syndrome (TTS) differs from primary TTS in terms of clinical characteristics, management, and prognosis. COPD exacerbation has been recognized as a physical trigger for TTS, but its prognostic implications for secondary TTS are poorly understood.

Objectives

The purpose of this study was to examine the effects of COPD on in-hospital outcomes in TTS patients.

Methods

Using data from the National Inpatient Sample, patients with a primary diagnosis of COPD and a secondary diagnosis of TTS were identified (COPD-TTS group). Patients with a primary diagnosis of TTS and comorbid COPD were selected as a control group (TTS-COPD group). Then, we compared the in-hospital mortality and the incidence of adverse events before and after propensity score matching.

Results

603 patients were included in each of the TTS-COPD and COPD-TTS groups after matching. In both groups, the average age of included patients was about 68 years, and more than 85 percent of them were female. There were no statistically significant differences in the in-hospital mortality or the incident of cardiac arrest, ventricular arrhythmias, and AKI, between the two groups (All, p > 0.05). Patients with COPD-TTS had a higher rate of acute respiratory failure (ARF) (p < 0.001), a lower rate of cardiogenic shock (p = 0.001), and a longer length of hospital stay (LOS) (p < 0.001) compared to patients with TTS-COPD.

Conclusions

Patients with COPD-TTS had a higher rate of ARF and a longer LOS but a lower risk of cardiogenic shock compared to patients with TTS-COPD.

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.