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Abstract：
Introduction Pre-eclampsia is a pregnancy-associated multisystem disorder; in rare cases, it can be complicated by arrhythmias such as ventricular tachycardia (VT). The purpose of this study was to determine the prevalence and predictors of VT among patients admitted with pre-eclampsia as well as to analyze the independent association of VT with in-hospital outcomes in this population. Methods Data were obtained from the National Inpatient Sample from January 2016 to December 2019. Patients with a primary diagnosis of pre-eclampsia were selected using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. Subsequently, the study population was divided into patients who developed VT versus patients who did not develop this complication. We then assessed the predictors of VT in women with pre-eclampsia as well as the independent association of VT with outcomes taking into account confounders such as age, race, and comorbidities. Results Of 255,946 patients with pre-eclampsia, 92 developed VT (0.04%) during their hospital stay. Multivariate logistic regression showed that patients with VT were far more likely to develop cardiac arrest (adjusted odds ratio, or aOR: 92.582, 95% CI: 30.958-276.871, p=0.001), require permanent pacemaker implantation (aOR: 41.866, 95% CI: 14.800-118.432, p=0.001), develop postpartum hemorrhage (aOR: 2.932, 95% CI: 1.655-5.196, p=0.001), and require left heart catheterization (aOR: 19.508, 95% CI: 3.261-116.708, p=0.001). Predictors of VT included being African American (aOR: 1.939, 95% CI: 1.183-3.177, p=0.009), cerebrovascular disease (aOR: 23.109, 95% CI: 6.953-76.802, p=0.001), congestive heart failure (aOR: 50.340, 95% CI: 28.829-87.901, p=0.001), atrial fibrillation (aOR: 20.148, 95% CI: 6.179-65.690, p=0.001), and obstructive sleep apnea, or OSA (aOR: 3.951, 95% CI: 1.486-10.505, p=0.006). Patients in the VT cohort were found to have an increased length of hospital stay compared to the non-VT cohort (7.16 vs. 4.13 days, p=0.001). Conclusion In a large cohort of women admitted with pre-eclampsia, we found the prevalence of VT to be <1%. Predictors of VT included conditions such as atrial fibrillation, congestive heart failure, and OSA and being African American. VT was found to be independently associated with several adverse outcomes as well as an increased length of hospital stay.
摘要：
介绍先兆子痫是一种妊娠相关的多系统疾病;在极少数情况下，它可以并发心律失常，如室性心动过速（VT）。这项研究的目的是确定先兆子痫患者中VT的患病率和预测因素，并分析该人群中VT与院内预后的独立关联。方法数据来自2016年1月至2019年12月的全国住院患者样本。使用国际疾病分类选择主要诊断为先兆子痫的患者，第十次修订,临床修改（ICD-10-CM）代码。随后，研究人群分为发生VT的患者和未发生这种并发症的患者.然后，我们评估了子痫前期女性的VT预测因子，以及考虑到年龄等混杂因素，VT与结局的独立关联。种族,和合并症。结果255946例子痫前期患者中,92人在住院期间发生室性心动过速(0.04%)。多因素logistic回归显示，室性心动过速患者发生心脏骤停的可能性更大（调整后的比值比，或OR：92.582，95%CI：30.958-276.871，p=0.001），需要永久性起搏器植入(aOR:41.866,95%CI:14.800-118.432,p=0.001),发生产后出血（aOR：2.932，95%CI：1.655-5.196，p=0.001），需要左心导管检查(aOR:19.508,95%CI:3.261-116.708,p=0.001)。VT的预测因素包括非裔美国人（aOR：1.939，95％CI：1.183-3.177，p=0.009），脑血管疾病（aOR：23.109，95%CI：6.953-76.802，p=0.001），充血性心力衰竭（aOR：50.340，95％CI：28.829-87.901，p=0.001），心房颤动（aOR：20.148，95%CI：6.179-65.690，p=0.001），和阻塞性睡眠呼吸暂停，或OSA（AOR：3.951，95%CI：1.486-10.505，p=0.006）。与非VT队列相比，VT队列中的患者住院时间增加（7.16vs.4.13天,p=0.001)。结论在一大群先兆子痫患者中，我们发现室性心动过速的患病率<1%.室性心动过速的预测因素包括心房颤动等疾病，充血性心力衰竭,和OSA，是非洲裔美国人。发现室性心动过速与几种不良结局以及住院时间增加独立相关。
