影响持续性房颤患者急诊再就诊的相关因素分析

The related risked factors of emergency department re-visits for patients with symptomatic atrial fibrillation

目的对影响持续性房颤患者急诊再就诊的相关因素进行分析。方法对因持续性房颤相关主诉而入急诊室的患者180例并随访30天,依据患者30天之内是否再就诊分为再就诊组(共48例)和未再就诊组(共132例),观察影响这些患者再就诊的相关因素。结果按照是否再就诊对观察变量结果行χ2检验,结果显示左房横径(P=0.002)、心室率控制情况(P=0.004)、应用地高辛(P=0.048)、吸烟(P=0.002)、合并糖尿病(P=0.013)和心力衰竭(P=0.040)在两组间差异有显著性。多因素Logistic回归分析显示,结果显示左房横径≥45mm(OR=0.023,P=0.001),心室率≥100次/分(OR=0.024,P=0.003),未应用地高辛(OR=0.879,P=0.027)、吸烟(OR=1.309,P=0.001)、合并心力衰竭者(OR=1.042,P=0.018)和糖尿病(OR=3.74,P=0.012)者,30天之内更容易因为持续性房颤相关主诉再就诊。结论影响持续性房颤患者急诊再就诊的相关因素包括左房横径≥45mm,心室率控制不理想、未应用地高辛、吸烟、合并心力衰竭和糖尿病。

Objective To investigate the related risked factors of emergency department（ ED） re-visits for Patients with symptomatic atrial fibrillation. Method 180 Patients from March 2009 to April 2011 with symptomatic atrial fibrillation in ED were followed up by 30 days,and were classified into 2 groups according re-visits or not： Group 1（ re-visits,n = 48）; Group 2（ no re-visits,n = 132）,we assess the related risked factors of emergency department（ ED） re-visits for patients with symptomatic atrial fibrillation. Result The difference of left atrium diameter（ P =0. 002）,ventricular rate control（ P = 0. 004） l,home digitalis use（ P = 0. 048）,smoking（ P = 0. 002）,history of diabete（ P = 0. 013）,history of heart failure（ P = 0. 040） between re-visits and no re-visits groups was significant.Results of multivatiate logistic regression showed left atrium diameter no less than 45mm（ OR = 0. 023,P = 0. 001）,inadequate ventricular rate contro（ OR = 0. 024,P = 0. 003） l,no home digitalis use（ OR = 0. 879,P = 0. 027）,smoking（ OR = 1. 309,P = 0. 001）,history of heart failure（ OR = 1. 042,P = 0. 018）,history of diabetes（ OR = 3.74,P = 0. 012） in ED patients with symptomatic atrial fibrillation were associated with an increased risk of emergency department re-visits in 30 days. Conclusion In ED patients with symptomatic atrial fibrillation,left atrium diameter no less than 45 mm,inadequate ventricular rate control,no home digitalis use,smoking,history of heart failure,history of diabetes were associated with an increased risk of emergency department re-visits in 30 days.