Risk factors of death during hospitalization in adult patients with fulminant myocarditis
Zhao Han
Liu Wenxian
Ren Yanlong
Ning Shangqiu
He Weihong
Abstract：Objective To analyze the risk factors of death during hospitalization in adult patients with fulminant myocarditis.Methods Clinical data of 50 patients over 18 years old with fulminant myocarditis hospitalized in Beijing Anzhen Hospital,Capital Medical University between January 2007 and December 2017 were retrospectively analyzed.The patients were divided into in-hospital death group(7 cases) and survival group (43 cases).Influence factors of death were analyzed.Results Compared with survival group,patients in death group were older[45 (35,55) years vs 27 (21,34) years],the proportion of women was higher [6/7 vs 18/43],systolic blood pressure on admission was lower[(83 ± 13)mmHg vs (101 ± 19)mmHg] (all P ＜ 0.05).Hemoglobin level in death group was significantly lower than that in survival group[(112 ± 26)g/L vs (134 ± 18)g/L];the peak value of troponin I,the peak value of creatine kinase isoenzyme and D-dimer level in death group were significantly higher than those in survival group [102 (67,102)μg/L vs 16 (6,47)μg/L;171 (101,268)μg/L vs 61(14,116) μg/L;5 583(558,16 979) μg/L vs 408(173,1 769) μg/L] (all P ＜0.05).In death group there were wilder QRS wave at peak[172(146,200) ms vs 138 (102,158)ms],higher incidence of ventricular flutter or ventricular fibrillation (4/7 vs 3/43),higher use rates of vasoactive drugs,ventilator and intra-aortic balloon counterpulsation(7/7 vs 24/43,7/7 vs 7/43,3/7 vs 3/43) as compared with survival group(all P ＜ 0.05).Predictive value of peak QRS wave width for death during hospitalization was analyzed using receiver operating characteristic curve,showing that the area under curve was 0.761,standard error was 0.081,P =0.028,95％ confidence interval was 0.603-0.919;when QRS =145 ms was taken as cut off value,the sensitivity and specificity in predicting death during hospitalization were 85.7％ and 60.5％,respectively.Conclusions Among adult patients with fulminant myocarditis,female patients are associated with high mortality during hospitalization;peak QRS wave width shows certain predictive value for in-hospital death.
Keywords：Fulminant myocarditisDeath during hospitalizationRisk factors
Publication Date：2020-01-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 13-17 )