背景:心房颤动(AF)是全球最常见的心律失常。有关发展中国家房颤指数入院后新的充血性心力衰竭(CHF)的再入院数据描述不佳。
目的:这项研究旨在评估发病率,预测因子,以及叙利亚房颤指数入院后120天CHF再入院的结果。
方法:这项回顾性队列研究收集了所有在2021年6月至2023年12月期间因房颤进入拉塔基亚三级中心的无已知CHF的成年患者。数据取自患者的医疗记录。主要结果包括在指数出院的120以内再入院,发生CHF,次要结局包括这些CHF再入院的预测因素和结局.
结果:共有660名患者被纳入最终分析,其中69例(11.7%)在出院后120天内再次接受新的CHF。再次入院的患者中位年龄较高(58岁vs70岁,p<.001)。独立增加120天CHF发病率的因素是年龄≥60岁(HR:9.8,95%CI:4.8-23.6,p<.001),糖尿病(DM)(HR:2.9,95%CI:1.7-4.9,p<.001),心脏瓣膜病(VHD)(HR:1.7,95%CI:1.04-2.78,p=0.047),和高血压(HR:2.5,95%CI:1.5-4,p<.001)。住院患者死亡发生在6名再次入院的患者中(9%)。LVEF<40%(HR:6.7,95%CI:24.31,p=0.01)和DM(HR:7.2,95%CI:1.9-33,p=.004)与住院患者死亡率独立相关。
结论:新的CHF住院在叙利亚房颤出院患者中很常见。发生CHF的临床预测因素强调了生活方式风险因素和房颤患者常见合并症的综合管理的重要性,以优化资源枯竭社区的预后。
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia worldwide. Data regarding readmission for new congestive heart failure (CHF) following index admission for AF in the developing world are poorly described.
OBJECTIVE: The study aimed to assess the rate, predictors, and outcomes of 120-day CHF readmission after index admission for AF in Syria.
METHODS: This retrospective cohort study collected all adult patients without known CHF who had an index admission with AF to Latakia\'s tertiary center between June 2021-December 2023. Data were taken from patients\' medical notes. The primary outcome included readmission with incident CHF within 120 of index discharge, and secondary outcomes included predictors and outcomes of these CHF readmissions.
RESULTS: A total of 660 patients were included in the final analysis, of which 69 (11.7%) were readmitted with new CHF within 120 days of index discharge. Readmitted patients had higher median age (58 vs 70 years, p < .001). Factors that independently increased 120-day CHF incidence were age ≥60 years (HR: 9.8, 95% CI: 4.8-23.6, p < .001), diabetes mellitus (DM) (HR:2.9, 95% CI:1.7-4.9, p < .001), valvular heart disease (VHD) (HR:1.7, 95% CI:1.04-2.78, p = .047), and hypertension (HR:2.5, 95% CI:1.5-4, p < .001). Inpatient mortality occurred in six readmitted patients (9%). LVEF <40% (HR:6.7, 95% CI: 24.31, p = .01) and DM (HR:7.2, 95% CI: 1.9-33, p = .004) were independently associated with inpatient mortality.
CONCLUSIONS: Hospitalization for new CHF was common in Syrian patients discharged with AF. The clinical predictors of incident CHF emphasize the importance of integrated management of lifestyle risk factors and common comorbidities in AF patients to optimize outcomes in resource-depleted communities.