Analysis of the distribution of clinical characteristics of inpatients in the China Atrial Fibrillation Center of Hainan Traditional Chinese Medicine Hospital
10.3969/j.issn.1008-9691.2023.06.014
- VernacularTitle:海南省中医院心房颤动中心住院患者临床特征分布情况分析
- Author:
Pinhui LI
1
;
Zhengxin HUANG
;
Meng JI
Author Information
1. 海南省中医院心内科,海南海口 570200
- Keywords:
China Atrial Fibrillation Center;
Hospitalized population;
Clinical features
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2023;30(6):706-712
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the population distribution pattern of inpatients in the China Atrial Fibrillation Center of Hainan Traditional Chinese Medicine Hospital to guide clinical diagnosis and treatment.Methods Clinical diagnosis and treatment(including hospitalization information,diagnosis and treatment,symptoms,health assessment,physical examination,examination,testing,therapeutic drugs),European Heart Rhythm Association(EHRA)symptom score,CHA2DS2-VASc score for predicting stroke risk stratification in atrial fibrillation,HAS-BLED score for predicting bleeding risk in anticoagulated were collected from Hainan Traditional Chinese Medicine Hospital from October 2020 to September 2022 in the data filling platform of China Atrial Fibrillation Center through retrospective investigation.The normal reference values of various examination indicators set for analysis are heart rate 60-100 beats/min,QTc interval <480 ms for males and<470 ms for females,ejection fraction(EF)0.50-0.75 for B-ultrasound,left atrial anteroposterior diameter <35 mm,left ventricular end-diastolic diameter(LVEDD)<55 mm for males and <50 mm for females,no left atrial thrombosis,International normalized ratio(INR)0.85-1.20,brain natriuretic peptide(BNP)0-100 ng/L,N-terminal pro-brain natriuretic peptide(NT-proBNP)0-125 ng/L in cardiology,0-250 ng/L in non cardiology.Results Among 667 patients,there were 39 cases of valvular atrial fibrillation and 628 cases of non valvular atrial fibrillation.The completion rate of various diagnostic(physical examination/examination/testing)indicators was 19.94％-100.00％.Statistically significant differences were showed in every EHRA symptom score,HAS-BLED score,BMI,hypertension,heart rate,EF,left atrial diameter,LVEDD,left atrial thrombus,INR(Warfarin user),BNP,NT-proBNP and atrial fibrillation treatment methods(all P<0.01).No statistically significant difference was shown in CHA2DS2-VASc scores for each gender,QTc and NT-proBNP(all P>0.05).409 patients were treated with antiarrhythmic drugs,with a treatment rate of 61.32％.Statistically significant difference was showed in the proportion of medication use among different populations with heart rates of<60,60-100,and ≥100 beats/min,respectively[46.51％(20/43)vs.54.60％(196/359),72.83％(193/265),P<0.01],and the highest drug usage rate was β receptor blockers.Statistically significant difference was shown in the use rate of different antiarrhythmic drugs(P<0.01).There were 342 patients treated with anticoagulant therapy,with a treatment rate of 51.27％,the treatment rate of valvular atrial fibrillation was significantly higher than that of non-valvular atrial fibrillation[84.62％(33/39)vs.49.20％(309/628)],with a statistically significant difference(P<0.01).No statistically significant difference was shown in treatment rates between individuals with CHA2DS2-VASc scores of ≥2 for males and ≥3 for females of non-valvular atrial fibrillation,and between individuals with CHA2DS2-VASc scores of <2 for males and <3 for females,as well as between individuals with HAS-BLED scores of ≤2 and ≥3 for treatment rates(all P>0.05).Statistically significant differences were shown in the usage rates of different anticoagulants,antiplatelet aggregation drugs,blood lipid control(statins)drugs,and blood pressure control drugs(all P<0.01).The types of medication used for blood pressure control are angiotensin converting enzyme inhibitor(ACEI),angiotensin Ⅱ receptor blocker(ARB),calcium channel blocker(CCB),β receptor blockers and diuretics.The single drug composition ratio of the medication plan was the highest(39.75％),and the diuretics composition ratio of drug use was the highest(48.00％),with statistically significant differences(all P<0.01).Conclusions The operation of the Atrial Fibrillation Center of Hainan Traditional Chinese Medicine Hospital has covered all clinical diagnosis and treatment projects,and the treatment plan is consistent with the guidelines.At present,the control of blood pressure,BMI,and heart rate of hospitalized patients needs to be further strengthened,especially the proportion of high-risk people with stroke,and there is insufficient anticoagulation treatment.The training of the guidelines should be improved to promote standardized treatment.
