心房颤动患者住院病死率的影响因素单中心研究

Factors affecting in-hospital mortality of atrial fibrillation patients:a single-center study.

目的探索心房颤动(简称房颤)住院患者的死亡率以及影响因素。方法采用北京同仁医院2008年9月至2018年12月出院的6668例房颤患者作为研究对象。统计住院患者的病死率,采用单因素和多因素logistic回归的方法分析影响房颤住院病死率的影响因素。结果共388例房颤患者(平均年龄71.47岁,男性,56.0%)在住院期间死亡,发生率达5.81%。多因素分析提示高龄(OR 1.05,95%CI 1.03~1.07,P<0.001),慢性肾病病史(OR 3.10,95%CI 2.26~4.25,P<0.001),贫血(OR 4.13,95%CI 3.04~5.60,P<0.001)和恶性肿瘤病史(OR 1.96,95%CI 1.39~2.78,P<0.001)是住院病死患者的特征,脂代谢异常(OR 0.50,95%CI 0.36~0.70,P<0.001),稍大的左房内径(OR 0.52,95%CI 0.41~0.67,P<0.001),更高的左室射血分数(OR 0.95,95%CI 0.94~0.96,P<0.001)有助于减低住院病死率。结论贫血、CKD、肿瘤、高龄增加房颤患者的住院死亡率,但是较好的心功能降低住院患者死亡率。

Objective To explore the mortality of inpatients with AF and its influencing factors.Methods Totally 6668 patients with AF discharged from Beijing Tongren Hospital from September 2008 to December 2018 were selected.The mortality of the inpatients was studied.Univariate and multivariate logistic regression were used to explore the impact factors of the in-hospital mortality of AF.Results Totally 388 AF patients(mean age 71.47 years,male,56.0%)died in hospital,the incidence being 5.81%.Multivariate analysis showed that old age(OR1.05,95%CI 1.03-1.07,P<0.001),chronic kidney disease history(OR 3.10,95%CI 2.26-4.25,P<0.001),anemia(OR 4.13,95%CI 3.04-5.60,P<0.001)and malignant tumor history(OR 1.96,95%CI 1.39-2.78,P<0.001)were the features of in-patient mortality,while dyslipidemia(OR 0.50,95%CI 0.36-0.70,P<0.001),the larger left atrial diameter(OR 0.52,95%CI 0.41-0.67,P<0.001)and the higher left ventricular ejection fraction(OR 0.95,95%CI 0.94-0.96,P<0.001)helped to lower in-patient mortality.Conclusion Anemia,CKD,tumor and old age increase the in-hospital mortality of AF patients,but better cardiac function reduces the in-hospital mortality。