心脏植入器械数据库的分析和预警指标的建立

Analysis of the Database of Cardiac Implants and Establishment of Early Warning Indicators

摘要: 目的：观察心脏植入器械患者两年内心律失常的发生率如房颤，心衰的发生率，及其他心血管事件。方法：纳入北京地区4家医院从2010年1月至2019年10月(北京医院，阜外医院，安贞医院和普仁医院)心脏植入器械老年患者(年龄 ≥ 60岁)，根据心脏器械植入适应症，器械植入类型及器械植入后的各种参数等建立数据库，并收集患者疾病相关的基础资料。分析纳入患者的心血管事件发生情况。结果本次研究共获得662例患者样本，其中有28位患者由于数据缺失进行了剔除，因此共获得589例有效样本。结果分析发现，心脏植入器械监测心血管事件发生数量与临床诊断之比最高为1:0.2，最低为1:1.22。心脏植入器械患者监测与临床诊断心血管事件发生情况的效率没有统计学差异，利用ROC曲线分析发现心脏植入器械监测心血管事件发生情况AUC > 0.7 (P < 0.05)。结论：心脏植入器械数据库得出的数据能够对心血管事件进行良好的监测。

Abstract: Purpose: to observe the incidence of arrhythmias such as atrial fibrillation, heart failure, and other cardiovascular events in patients with heart implants within two years. Methods: Elderly patients (aged ≥ 60 years old) with heart implant devices were included in 4 hospitals (Beijing Hospital, Fuwai Hospital, Anzhen Hospital and Puren Hospital) in Beijing from January 2010 to December 2019. A database was established based on indications of cardiac device implantation, types of device implantation and various parameters after device implantation, and the basic information related to patients’ diseases was collected. The incidence of cardiovascular events in the included patients was analyzed. Results: In this study, a total of 662 patient samples were obtained, among which 28 patients were excluded due to lack of data, so a total of 589 valid samples were obtained. The results showed that the ratio of the number of cardiovascular events monitored by the cardiac implant to the clinical diagnosis was 1:0.2 at the highest and 1:1.22 at the lowest. There was no statistical difference in the efficiency of monitoring and clinical diagnosis of cardiovascular events in patients with heart implant devices. The ROC curve analysis showed that cardiac implants monitor cardiovascular events AUC > 0.7 (P < 0.05). Conclusion: The data from the heart implant device database can provide good monitoring of cardiovascular events.