medigraphic.com
ISSN 1810-2352 (Print)

2019, Number 2

<< Back Next >>

Rev Cub Med Int Emerg 2019; 18 (2)

Probability model of death for cardiac arrhythmia in patients with ischemic cardiomyopathy

Elias SR, Pérez CJ, Elias AKS, Osorio FD

Language: Spanish
References: 19
Page: 1-14
PDF size: 277.16 Kb.


ABSTRACT

Introduction: Determining the prognosis of patients with ischemic cardiomyopathy is a requirement of the clinical method and a challenge for the intensives.
Objective: To identify the associate factors of heart arrhythmia mortality in patients with ischemic cardiomyopathy.
Method: An observational, analytical, retrospective and longitudinal study was conducted in the intensive care unit at Dr. Agostinho Netoˮ Hospital. The patients were grouped according to their discharge into deaths due to cardiac arrhythmia (N= 12) or alive (N= 38). We analyzed clinical variables, echocardiography, electrocardiography, personal history, and patient status at discharge. We calculated the absolute risk of the most frequent variables and those most related to the probability that the patient died. A patient probability model was designed if the patient died due to cardiac arrhythmia with ischemic cardiomyopathy.
Results: The variables most associated with the prognosis of dying were the signs of pulmonary congestion, cardiac cyanosis and segmental dysfunction, and increase in left ventricular end-diastolic diameter (ultrasound). The absolute risk for these variables was 22.4.
Conclusion: We identified the factors associated with the risk of the patient with ischemic cardiomyopathy of dying due to cardiac arrhythmia, which enabled the elaboration of a probability of death model due to this cause. The presence of signs of pulmonary congestion, segmental dysfunction and the increase in left ventricular end-diastolic diameter were this risk most related factors.


REFERENCES

  1. Degrauwe S, Zuffi A, Muller O, Schiele F, Eeckhout E, Iglesias JF. Very late multiple recurrent spontaneous coronary artery dissection in a young woman with recidivating acute myocardial infarction. Int J Cardiol. 2016 acceso: 06/05/2018;223:168-70. Disponible en: http://doi:10.1016/j.ijcard.2016.08.124

  2. Cuba. Ministerio de Salud Pública. Dirección de Registros Médicos y Estadísticas de Salud. Anuario estadístico de salud. 2017 Ago [acceso: 02/05/2018]. p. 27. Disponible en: http://www.sld.cu/sitios/dne

  3. Rodríguez RH, Muñoz GM, Márquez MF, Pozas GG, Asensio LE, Ortíz GF, y otros. Muerte súbita cardiaca. Estratificación de riesgo, prevención y tratamiento. Arch Cardiol Mex. 2015 Ago [acceso: 02/05/2018];85(4):329-336. Disponible en: http://dx.doi.org/10.1016/j.acmx.2015.06.002

  4. Araya VJ. Canalopatías en muerte súbita. Medicina Legal de Costa Rica. Edición virtual. 2017 Ago [acceso: 02/05/2018];34(1):1409-15. Disponible en: http://www.scielo.sa.cr/pdf/mlcr/v34n1/1409-0015-mlcr-34-01-00272.pdf

  5. Hashemian M, Poustchi H, Hekmatdoost A. Systematic review of indicators and risk of coronary heart disease. 2015 acceso: 06/05/2018;11(6):357-65. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/26862344

  6. Franco J, Formiga F, Chivite D, Corbella X, Robert J, Vidaller A, et al. Insuficiencia cardiaca aguda en el anciano. Rev Colomb Cardiol. 2017 Ago [acceso: 02/05/2018];24(3):250-4. Disponible en: http://dx.doi.org/10.1016/j.rccar.2016.10.040

  7. Rosiek A, Leksowski K. The risk factors and prevention of cardiovascular disease. Ther Clin Risk Manag. 2016, Aug acceso: 06/05/2018;12:1223-9. Disponible en: http://doi:10.2147/TCRM.S107849.eCollection 2016

  8. Llorens P, Manito LN, Manzano EL, Martín SFJ, Comín CJ, Formiga F, et al. Consenso para la mejora de la atención integral a los pacientes con insuficiencia cardiaca aguda. Emergencias. 2015, May [acceso: 02/05/2018];27(4):245-66. Disponible en: https://medes.com/publication/101997

  9. Avilés SGE. Framework para evaluación de modelos predictivos en señales electrocardiográficas con aplicación en la detección de arritmias [Tesis de grado]. Universidad de Chile; 2016 [acceso: 06/05/2018]. Disponible en: http://repositorio.uchile.cl/handle/2250/143346

  10. Rodríguez RH, Muñoz GM, Márquez MF, Pozas GG, Asensio LE, Ortíz GF, et al. Muerte súbita cardiaca. Estratificación de riesgo, prevención y tratamiento. Arch. Cardiol. Méx. 2015, Dic [acceso: 02/05/2018];85(4):45-56. Disponible en: http://www.scielo.org.mx/pdf/acm/v85n4/1405-9940-acm-85-04-00329.pdf

  11. Wellens HJJ, Schwartz PJ, Lindemans FW, Buxton AE, Goldberger JJ, Hohnloser SH, et al. Risk stratification for sudden cardiac death: Current status and challenges for the future. Eur Heart J. 2014 [acceso: 02/05/2018];35(25):1642-51. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076664/

  12. Niemeijer MN, van den Berg ME, Leening MJ, Hofman A , Franco OH, Deckers JW, et al. Declining incidence of sudden cardiac death from 1990-2010 in a general middle-aged and elderly population: The Rotterdam Study. Heart Rhythm. 2015, Jan [acceso: 02/05/2018];12(1):123-9. Disponible en: https://doi: 10.1016/j.hrthm.2014.09.054. PMID: 25277989

  13. Jeffrey J, Goldberger, Haris Subačius, Taral Patel, Ryan Cunnane, Alan H. Cardiac death risk stratification in patients with nonischemic dilated cardiomyopathy. Am Coll Cardiol. 2014, May [acceso: 02/05/2018];63(18):1879-89. Disponible en: http://content.onlinejacc.org/article.aspx?articleID=1827541

  14. Álvarez AL. Estratificación de muerte súbita en pacientes con miocardiopatía dilatada no isquémica. Cardiología hoy [Blog en Internet]. 2014, Jun [acceso: 02/05/2018]. Disponible en: https://secardiologia.es/multimedia/blog/5365-estratificacion-muerte-subita-pacientes-miocardiopatia-dilatada-no-isquemica

  15. Sálica G. Estratificación de riesgo mediante variables eléctricas en insuficiencia cardiaca. Rev Fed Arg Cardiol. 2015, May [acceso: 02/05/2018];44(4):200-5. Disponible en: http://www.fac.org.ar/2/revista/15v44n4/revision/01/ salica.pdf

  16. Salica G, Bonacina J. Estratificación de riesgo en insuficiencia cardiaca mediante variables eléctricas (parte II). Rev Fed Arg Cardiol. 2017, May [acceso: 02/05/2018];46(1):10-4. Disponible en: http://www.fac.org.ar/2/revista/17v46n1/revision/02/salica.pdf

  17. Stiell IG, Clement CM, Brison RJ, Rowe BH, Borgundvaag B, Aaron SD, et al. A risk scoring system to identify emergency department patients with heart failure at high risk for serious adverse events. Emergency Medicine. 2013;20(1):17-26.

  18. Cleland JG, Chiswell K, Teerlink JR, Stevens S, Fiuzat M, Givertz MM, et al. Predictors of postdischarge outcomes from information acquired shortly after admission for acute heart failure: a report from the Placebo-Controlled Randomized Study of the Selective A1 Adenosine Receptor Antagonist Rolofylline for Patients Hospitalized With Acute Decompensated Heart Failure and Volume Overload to Assess Treatment Effect on Congestion and Renal Function (PROTECT) Study. Circ Heart Fail. 2014;7(1):76-87.

  19. Lee DS, Stitt A, Austin PC, Stukel TA, Schull MJ, Chong A, et al. Prediction of heart failure mortality in emergent care: a cohort study. Ann Intern Med. 2012;156(11):767-75.




2020     |     www.medigraphic.com