BACKGROUND: Little is known about the risk factors for sudden cardiac death (SCD) in the overall hospitalized cardiac department population. This study was conducted to investigate the risk factors and develop a predictive model for SCD in a hospitalized cardiac department population. METHODS: We conducted a retrospective study of patients admitted to the cardiac department of the First Affiliated Hospital of Xinjiang Medical University from June 2015 to February 2017. We collected the clinical data from medical records. Multiple stepwise logistic regression analysis was carried out to confirm the risk factors for SCD and develop a predictive risk model. The risk score was assessed by the area under receiver operating characteristic (AUROC) curve and the Hosmer-Lemeshow goodness-of-fit test. RESULTS: A total of 262 patients with SCD and 4485 controls were enrolled in our study. Logistic regression modeling identified eight significant risk factors for in-hospital SCD: age, main admitting diagnosis, diabetes, corrected QT interval, QRS duration, ventricular premature beat burden, left ventricular ejection fraction, and estimated glomerular filtration rate. A predictive risk score including these variables showed an AUROC curve of 0.774 (95% confidence interval: 0.744-0.805). The Hosmer-Lemeshow goodness-of-fit test showed the chi-square value was 2.527 (P = 0.640). The incidence of in-hospital SCD was 1.3%, 4.1%, and 18.6% for scores of 0 to 2, 3 to 5 and ≥6, respectively (P < 0.001). CONCLUSIONS Age, main admitting diagnosis, diabetes, QTc interval, QRS duration, ventricular premature beat burden, left ventricular ejection fraction, and estimated glomerular filtration rate are factors related to in-hospital SCD in a hospitalized cardiac department population. We developed a predictive risk score including these factors that could identify patients who are predisposed to in-hospital SCD.
Aged ; Death, Sudden, Cardiac ; epidemiology ; Electrocardiography ; Female ; Glomerular Filtration Rate ; Humans ; Inpatients ; statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors

Humans ; Nutrition Surveys ; Diabetes Mellitus, Type 2/chemically induced* ; Environmental Exposure/analysis* ; Environmental Monitoring ; Phthalic Acids/toxicity* ; Environmental Pollutants/toxicity*

Objective:To investigate the effect of total ginsenoside ginseng root on the learning and memory impairment and anxiety of hindlimb suspension rats by detecting the performance of rats in the water maze， elevated plus maze， and the expression of hypothalamic-pituitary-adrenal （HPA） axis， inflammatory factors and tryptophan pathway related factors through the intervention of ginsenosides in hindlimb suspension rats. Method:The Wistar male rats were divided into normal group， hindlimb suspension model group， Huperzine A group （0.1 mg·kg^-1）， and total ginsenoside ginseng root low and high dose groups （100， 200 mg·kg^-1）， with 8 rats in each group. Except for the normal group， the rats in the other groups maintained a -30° hindlimb suspension state for 24 h. The normal group and the model group received intragastric administration of 10 mL·kg^-1 pure water . After 28 days of continuous administration， the water maze and elevated plus maze behavioral tests were performed. After the tests， blood was taken from the abdominal aorta， and the rat brain cortex was peeled off on ice， quenched with liquid nitrogen， and stored at -80 ℃ for later use. LC-MS/MS was used to detect neurotransmitter levels of dopamine， acetylcholine， glutamate， γ-aminobutyric acid and tryptophan pathway metabolites （tryptophan， 5-hydroxytryptamine， 5-hydroxyindoleacetic acid， kynurenine， 3-hydroxykynurenine， and kynurenine） in rat brain cortex. An enzyme-linked immunosorbent assay （ELISA） kit was used to detect the levels of inflammatory factors interleukin-6 （IL-6）， interleukin-10 （IL-10， the HPA axis-related hormone corticotropin （ACTH）， and the level of corticosterone （CORT）. Result:Compared with the normal group， the escape latency in the water maze significantly increased， the number of crossings was significantly reduced， and the number of open-arm entry and the percentage of open-arm entry were significantly reduced in the elevated plus maze in model group （P<0.05， P<0.01）， the content of dopamine， acetylcholine， glutamic acid， and γ-aminobutyric acid in the cortex decreased， kynurenine and kynurenic acid showed an upward trend， 3-hydroxykynurenine， 5-hydroxytryptamine， 5-hydroxyindole acetic acid showed a downward trend， and the levels of IL-6， IL-10， ACTH， and CORT in the serum significantly increased （P<0.05， P<0.01）. Compared with the model group of rats， total ginsenoside ginseng root low and high dose groups group reduced the avoidance latency in the water maze， and increased the number of crossings and the number of open arms of the elevated plus maze， dopamine， acetylcholine， glutamate， and γ-aminobutyl content increased， while kynurenine and kynurenic acid showed a downward trend， 3-hydroxykynurenine， serotonin， and 5-hydroxyindole acetic acid showed an upward trend， and IL-6， IL-10， ACTH， and CORT factor levels were down-regulated（P<0.05， P<0.01）. Conclusion:Hindlimb suspension for 28 days in simulated microgravity can impair the learning and memory ability of rats and cause anxiety-like behaviors. Total ginsenoside ginseng root can improve their learning and memory impairment and anxiety-like behaviors. The mechanism may be mainly related to inhibiting body inflammation and regulating HPA axis imbalance.