avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2018-8-5-389-393avk-841Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLEКЛИНИКО-СТАТИСТИЧЕСКИЙ АНАЛИЗ ПАЦИЕНТОВ С ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙCLINICAL AND STATISTICAL EVALUATION OF THE CALLS OF PATIENTS WITH ATRIAL FIBRILLATIONПлавуновН. Ф.PlavunovN. F.

Москва.

Moscow.

ГапоноваН. И.GaponovaN. I.

Москва.

Moscow.

КадышевВ. А.KadyshevV. A.

Москва.

Moscow.

АбдрахмановВ. Р.AbdrachmanovV. R.

Москва.

Moscow.

АкимовА. Е.AkimovA. E.

Москва.

Moscow.

КуликА. И.KulikA. I.

Москва.

Moscow.

ФГБОУ ВО «Московский государственный медико-стоматологический университет имени А.И. Евдокимова»; ГБУ «Станция скорой и неотложной медицинской помощи им. А.С. Пучкова».РоссияFederal State budget institution of higher education A.I. Yevdokimov Moscow State University of Medicine and Dentistry; First aid station named after A.S. Puchkov.Russian FederationФГБОУ ВО «Московский государственный медико-стоматологический университет имени А.И. Евдокимова».РоссияFederal State budget institution of higher education A.I. Yevdokimov Moscow State University of Medicine and Dentistry.Russian FederationГБУ «Станция скорой и неотложной медицинской помощи им. А.С. Пучкова».РоссияFirst aid station named after A.S. Puchkov.Russian Federation20180910201885389393Copyright © Плавунов Н.Ф., Гапонова Н.И., Кадышев В.А., Абдрахманов В.Р., Акимов А.Е., Кулик А.И., 20182018Плавунов Н.Ф., Гапонова Н.И., Кадышев В.А., Абдрахманов В.Р., Акимов А.Е., Кулик А.И.Plavunov N.F., Gaponova N.I., Kadyshev V.A., Abdrachmanov V.R., Akimov A.E., Kulik A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/841

Представлены результаты клинико-статистического анализа вызовов пациентов с фибрилляцией предсердий (ФП) по данным скорой медицинской помощи г. Москвы. Проведено добровольное анкетирование 5003 пациентов с ФП бригадами скорой медицинской помощи. Доля вызовов по поводу нарушений ритма сердца от общего числа сердечно-сосудистых заболеваний составила 17%, из них 88% приходится на ФП. Выявлена четкая тенденция преобладания пациентов с ФП у мужчин в трудоспособном возрасте, а у лиц женского пола в более старшем. Среди анкетируемых пациентов преобладает пароксизмальная форма ФП –70,1%. Средний балл по шкале оценки риска тромбоэмболических осложнений у больных с фибрилляцией/трепетанием предсердий CHA2DS2-VASc составил 3,56±1,71. Средний балл по шкале оценки риска ишемического инсульта у больных с неревматической фибрилляцией/трепетанием предсердий CHADS2 составил1,85±1.13. Число пациентов с суммой баллов два и более по обеим шкалам составило 87,7% и 59,3% соответственно. 28% пациентов с ФП обратились за медицинской помощью позднее 48 часов от начала приступа. Регулярное наблюдение кардиологом проводится в 50,5% случаев, терапевтом в 62,8%, совместно терапевтом и кардиологом в 45% соответственно. Постоянная пероральная антикоагулянтная терапия проводится у 29,8% пациентов с ФП. Процент медицинской эвакуации пациентов с ФП увеличился с 23,8% в 2015 г. до 27,1% в 2016г. Исследование показало, что необходим регулярный клинико-статистический анализ эффективности оказания медицинской помощи пациентам с ФП на всех этапах медицинского наблюдения.

This article presents the results of the clinical and statistical evaluation of the calls of patients with atrial fibrillation (AF) by the data of the emergency medical service in Moscow. Ambulance teams was performed a voluntary questionnaire survey of 5003 patients with AF. There were 17% of emergency calls for heart rhythm disturbances from the total number of cardiovascular diseases and 88% of these arrhythmias was AF. A clear trend was observed in the prevalence of AF in men of working age and in women in the older age group. Among the respondents prevails paroxysmal form of AF in 70.1% of cases. The average score on the risk scale of thromboembolic complications in patients with atrial fibrillation/flutter CHA2DS2-VASc was 3.56±1.71. The average score on the scale of risk assessment of ischemic stroke in patients with nonrheumatic atrial fibrillation/flutter CHADS2 was 1.85±1.13. The number of patients with a score of two or more on both scales was 87.7% and 59.3% respectively. 28% of patients with AF asked for medical help at least 48 hours after the onset of the paroxysm. Regular observation by a cardiologist is carried out in 50.5% of cases, by a therapist in 62.8%, jointly by a therapist and a cardiologist in 45% respectively. Continuous oral anticoagulant therapy is performed in 29.8% of patients with AF. The percentage of medical evacuations of patients with AF increased from 23.8% in 2015 to 27.1% in 2016. The study showed that regular clinical and statistical analysis of the effectiveness of medical care for patients with AF at all stages of medical surveillance is necessary.

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The authors declare that there are no conflicts of interest present.