RISK FACTORS FOR SUDDEN CARDIAC DEATH IN HOSPITAL PATIENTS

Highlights

• The study analyzed social factors, comorbidities, hospitalization characteristics, and laboratory and instrumental parameters in patients who died from sudden cardiac death (SCD) in a hospital setting. A multivariate Cox regression model was developed to predict the risk of death based on the identified SCD predictors.

Aim. To identify factors influencing the risk of SCD in hospitalized patients.

Methods. A retrospective analysis of 150 medical records was conducted at the Krasnoyarsk Regional Clinical Hospital from 2018 to 2023. Among them, 75 cases (50,0%) of in-hospital sudden cardiac death (SCD) were identified, including 42 men and 33 women aged 35 to 82 years. The remaining 75 patients (50,0%) with an equivalent age and sex distribution who underwent inpatient treatment at the same institution and were subsequently discharged formed the control group. Over 100 parameters were analyzed, including patient social characteristics, hospitalization characteristics, severity of condition, comorbidities, and changes in laboratory and instrumental parameters.

Results. According to the results of the univariate Cox regression analysis, the greatest contribution to the risk of sudden cardiac death (SCD) was associated with an increased time from disease onset to hospitalization, the presence of coronary heart disease (CHD), chronic heart failure, arterial hypertension, ECG-detected tachycardia, and disability status. In the multivariate Cox regression model, three independent predictors were significantly associated with an increased risk of SCD: longer time to hospitalization (HR = 1.48; 95% CI 1.23–1.78), presence of disability (HR = 1.83; 95% CI 1.09–3.07), and CHD (HR = 2.02; 95% CI 1.13–3.64). The constructed model demonstrated strong prognostic performance (C-index = 0.74; ROC-AUC = 0.91; Se = 0.84; Sp = 0.82), indicating its clinical utility for risk stratification of SCD in hospitalized patients.

Conclusion. Timely medical attention for patients with risk factors for SCD can reduce their mortality. Many SCD predictors can be identified through medical history collection and laboratory and instrumental diagnostics. A program has been developed for inpatient care that can calculate the risk of death based on the presence of SCD risk factors.

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