Effectiveness and costs of digoxin treatment for atrial fibrillation and flutter
| Autor: | Elsbeth G. Ritz, Peter H. Vlasses, David M. Salerno, Sheila A. Roberts, Paul E. Nolan, Claro Diaz, Arthur S. Zbrozek, Jerry L. Bauman, J.Stephan Stapczynski |
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| Rok vydání: | 1993 |
| Předmět: |
Male
medicine.medical_specialty Digoxin Heart disease Combination therapy Drug Costs law.invention Hospitals University law Internal medicine Atrial Fibrillation medicine Humans Sinus rhythm cardiovascular diseases Prospective Studies Aged business.industry Atrial fibrillation Length of Stay Middle Aged medicine.disease Intensive care unit United States Treatment Outcome Atrial Flutter Concomitant cardiovascular system Cardiology Regression Analysis Drug Therapy Combination Female Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents Atrial flutter medicine.drug |
| Zdroj: | The American journal of cardiology. 72(7) |
| ISSN: | 0002-9149 |
| Popis: | Clinical outcomes and costs associated with the use of digoxin in atrial fibrillation and flutter were evaluated in a prospective, observational study at 18 academic medical centers in the United States. Data were collected on 115 patients (aged18 years) with atrial fibrillation or flutter who were treated with digoxin for rapid ventricular rate (or = 120 beats/min). The median time to ventricular rate control (i.e., resting ventricular rate100 beats/min, decrease in ventricular rate of20%, or sinus rhythm) was 11.6 hours from the first dose of digoxin for all evaluable patients (n = 105) and 9.5 hours for those only receiving digoxin (n = 64). Before ventricular rate control, the mean +/- SD dose of digoxin administered was 0.80 +/- 0.74 mg, and a mean of 1.4 +/- 1.8 serum digoxin concentrations were ordered per patient. Concomitant beta-blocker or calcium antagonist therapy was instituted in 47 patients (41%); in 19 of these, combination therapy was initiated within 2 hours. Adenosine was administered to 13 patients (11%). Patients spent a median of 4 days (range 1 to 25) in the hospital; 28% spent time in a coronary/intensive care unit and 79% in a telemetry bed. Loss of control (i.e., resting ventricular rate returned to120 beats/min) occurred at least once in 50% of patients and was associated with a longer hospital stay (p0.05). Based on 1991 data, the estimated mean hospital bed cost for patients with atrial fibrillation or flutter was $3,169 +/- $3,174.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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