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Abstract：
Introduction The purpose of this study was to determine the prevalence of ventricular tachycardia (VT) among patients admitted with takotsubo cardiomyopathy (TCM) as well as to analyze the predictors of VT and the predictors of mortality among patients admitted with TCM. Methods Data were obtained from the National Inpatient Sample (NIS) database from January 2016 to December 2019. Patients with a primary diagnosis of TCM were selected using ICD-10 code I51.81. Subsequently, the study population was divided into patients who developed VT vs. patients who did not develop this complication. We then used multivariate logistic regression to assess the predictors of VT in our patient cohort as well as the predictors of mortality among patients admitted with TCM. Results Of 40114 patients with TCM, 1923 developed VT (4.8%) during their hospital stay. Predictors of VT include atrial fibrillation (AF) (adjusted odds ratio (aOR): 1.592; 95% confidence interval (CI): 0.00-1.424; p=0.001), congestive heart failure (aOR: 1.451; 95% CI: 1.307-1.610; p=0.001), coagulopathy (aOR: 1.436; 95% CI: 1.150-1.793; p=0.001), and patients who self-identify in the race category as Other (aOR: 1.427; 95% CI: 1.086-1.875; p=0.011). Female sex was found to be protective against VT (aOR: 0.587; 95% CI: 0.526-0.656; p=0.001). Predictors of mortality among patients admitted with TCM include, among other factors, age (aOR: 1.014; 95% CI: 1.011-1.018; p=0.001), Asian or Pacific Islander race (aOR: 1.533; 95% CI: 1.197-1.964; p=0.001), Black race (aOR: 1.242; 95% CI: 1.062-1.452; p=0.007), VT (aOR: 1.754; 95% CI: 1.505-2.045; p=0.001), and AF (aOR: 1.441; 95% CI: 1.301-1.597; p=0.001). Some comorbidities that were protective against mortality in TCM include tobacco use disorder (aOR: 0.558; 95% CI: 0.255-0.925; p=0.028) and obstructive sleep apnea (aOR: 0.803; 95% CI: 0.651-0.990; p=0.028). The female sex was found to be protective against mortality (aOR: 0.532; 95% CI: 0.480-0.590; p=0.001). Conclusion In a large cohort of women admitted with TCM, we found the prevalence of VT to be 4.8%. Predictors of VT included conditions such as AF and congestive heart failure. The female sex was found to be protective against VT and protective against mortality among patients admitted with TCM.
摘要：
引言本研究的目的是确定Takotsubo心肌病（TCM）患者中室性心动过速（VT）的患病率，并分析VT的预测因素和中医患者死亡率的预测因素。方法数据来自2016年1月至2019年12月的国家住院患者样本（NIS）数据库。使用ICD-10代码I51.81选择中医初诊的患者。随后，研究人群分为发生VT的患者和没有发生这种并发症的患者。然后，我们使用多变量逻辑回归来评估患者队列中VT的预测因子以及中医入院患者死亡率的预测因子。结果40114例患者采用中医治疗,1923年在住院期间发生室性心动过速（4.8%）。室性心动过速的预测因素包括心房颤动(AF)(调整比值比(aOR):1.592;95%置信区间(CI):0.00-1.424;p=0.001),充血性心力衰竭（aOR：1.451;95％CI：1.307-1.610;p=0.001），凝血功能障碍（aOR：1.436;95％CI：1.150-1.793;p=0.001），和自我识别为其他种族类别的患者(aOR:1.427;95%CI:1.086-1.875;p=0.011)。发现女性对VT具有保护作用（aOR：0.587；95％CI：0.526-0.656；p=0.001）。中医入院患者死亡率的预测因素包括，在其他因素中，年龄（AOR：1.014；95%CI：1.011-1.018；p=0.001），亚洲或太平洋岛民种族（aOR：1.533;95％CI：1.197-1.964;p=0.001），黑人种族（AOR：1.242；95%CI：1.062-1.452；p=0.007），VT（aOR：1.754；95%CI：1.505-2.045；p=0.001），和AF（aOR：1.441；95%CI：1.301-1.597；p=0.001）。在中医中，一些可预防死亡率的合并症包括烟草使用障碍（aOR：0.558；95％CI：0.255-0.925；p=0.028）和阻塞性睡眠呼吸暂停（aOR：0.803；95％CI：0.651-0.990；p=0.028）。发现女性对死亡率具有保护作用（aOR：0.532；95％CI：0.480-0.590；p=0.001）。结论在一个大的队列中，中医收治的女性，我们发现VT的患病率为4.8%.VT的预测因素包括房颤和充血性心力衰竭等疾病。在接受中医治疗的患者中，发现女性对VT和死亡率具有保护作用。
