坦桑尼亚一家三级医院非心脏门诊就诊的60岁及以上成年人中心房颤动的患病率、临床特征及相关因素：一项横断面研究
Prevalence, clinical characteristics, and associated factors of atrial fibrillation among adults 60 years and older attending noncardiac outpatient clinics at a tertiary hospital in Tanzania: A cross-sectional study.
文献信息
| PMID | 42774365 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Kyara Alfred Ndisi |
| 作者单位 | Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. |
| 期刊 | Heart rhythm O2 |
| SCI 分区 | Q2 |
| IF | 2.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 心房颤动（AF）是全球最常见的心律失常，并与不良结局风险增加相关。年龄是AF的重要危险因素，60岁以后患病率急剧上升。尽管非洲老年人比例不断上升，但关于该人群AF负担的数据仍然匮乏。
目的： 本研究旨在确定坦桑尼亚一家三级医院非心脏门诊就诊的60岁及以上成年人中AF的患病率、临床特征及相关因素。
方法： 我们在2021年6月至2022年2月期间，于Muhimbili国家医院非心脏门诊对同意参加的60岁及以上成年人开展了一项横断面研究。使用结构化问卷收集参与者的社会人口学和临床特征。使用智能手机连接的单导联心电图（ECG）设备（KardiaMobile，AliveCor）对其进行AF筛查。疑似AF通过12导联ECG确认。采用多变量logistic回归确定与AF相关的因素。数据分析使用Stata 13版（StataCorp LLC）完成。
结果： 共纳入1055例患者，中位年龄为67岁（四分位距[IQR] 62-72）。44例参与者（4.2%）检出AF。仅1例AF患者既往被诊断。大多数AF患者的CHA2DS2-VASc卒中风险评分较高，女性和男性的中位数分别为4.0（IQR 3-5）和3.0（IQR 2-3）。年龄大于75岁（调整比值比[aOR] 3.12；置信区间[CI] 1.31-7.40；P = .01）、体重不足（aOR 8.46；CI 1.44-49.76；P = .018）、高血压（aOR 5.35；CI 2.46-11.62；P < .001）和阻塞性睡眠呼吸暂停（aOR 11.90；CI 4.74-29.88；P < .001）与AF独立相关。
结论： 在坦桑尼亚老年门诊患者中，AF常见且诊断不足，并伴有高卒中风险。在资源匮乏国家使用单导联ECG对老年人进行机会性AF筛查是可行的，并有可能减轻卒中负担。
英文摘要
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide and is associated with an increased risk of adverse outcomes. Age is an important risk factor for AF with a sharp rise in prevalence after the age of 60 years. Despite a rising share of older adults in Africa, there is a paucity of data regarding AF burden in this demographic.
OBJECTIVE: This study aimed to determine the prevalence, clinical characteristics, and associated factors of AF among adults 60 years and older attending noncardiac outpatient clinics at a tertiary hospital in Tanzania.
METHODS: We conducted a cross-sectional study among consenting adults aged 60 years and older at noncardiac outpatient clinics of Muhimbili National Hospital from June 2021 to February 2022. A structured questionnaire was used to collect sociodemographic and clinical characteristics of participants. They were screened for AF using a smartphone-connected single-lead electrocardiography (ECG) device (KardiaMobile, AliveCor). Probable AF was confirmed by 12-lead ECG. Multivariable logistic regression was used to determine factors associated with AF. Data analysis was performed using Stata version 13 (StataCorp LLC).
RESULTS: A total of 1055 patients were enrolled with a median age of 67 years (interquartile range [IQR] 62-72). AF was detected in 44 participants (4.2%). Only 1 participant with AF was previously diagnosed. Most patients with AF had high CHA2DS2-VASc stroke risk scores with a median of 4.0 (IQR 3-5) and 3.0 (IQR 2-3) in females and males, respectively. Age older than 75 years (adjusted odds ratio [aOR] 3.12; confidence interval [CI] 1.31-7.40; P = .01), being underweight (aOR 8.46; CI 1.44-49.76; P = .018), hypertension (aOR 5.35; CI 2.46-11.62; P < .001), and obstructive sleep apnea (aOR 11.90; CI 4.74-29.88; P < .001) were independently associated with AF.
CONCLUSION: AF is common and underdiagnosed and carries a high stroke risk among elderly outpatients in Tanzania. Opportunistic screening of the elderly for AF in low-resource countries with 1-lead ECG is feasible and has the potential to reduce the burden of stroke.