IN HOSPITAL OUTCOME OF VENTRICULAR ARRHYTHMIA STORM AT THE AGA KHAN UNIVERSITY HOSPITAL, KARACHI, PAKISTAN

Abstract

Objective: Our objective was to know the percent mortality of ventricular arrhythmia (VA) storm, its major leading factor and the predictors of in-hospital mortality of VA storm in our population.

Methodology: In this retrospective observational study conducted at The Aga Khan University Hospital Karachi, all patients with age ≥16, with VA storm were included. Baseline demographic, clinical characteristics, laboratory parameters and management interventions were recorded in pre prepared questionnaire. The data was analyzed using SPSS version 21.

Results: Of the total 74 patients, 86.5% were male, 77% were having monomorphic VT and 60.8% were in pulmonary edema. Hypertension (73%), IHD (63.5%), DM (48.6%) MR (56.8%) TR (50%) and LV dysfunctions were the commonest risk factors of VA storm. The mean hospital stay was 5.64 ± 5.63 and 59.5% patients were discharged home in stable condition. On bivariate analysis female gender, polymorphic VT, pulmonary edema, intubation, baseline hemoglobin levels, and baseline WBC counts were predictors of in-hospital mortality of VA storm with hazard ratios (HR) of 2.22 [0.95-5.18], 2.44 [1.18-5.08], 13.49 [1.82-99.85], 17.54 [2.38-129.44], 1.25 [1.05-1.47], and 1.06 [1.01-1.11] respectively. On multivariate analysis, female gender, intubation, and baseline hemoglobin level were independent predictors of in-hospital mortality of VA storm with adjusted HRs of 3.88 [1.02-14.77], 9.9 [0.95-103.25], and 1.47 [1.2-1.79] respectively.

Conclusion: VA storm mortality for conservative management in our region is comparable to the international figures. Also we have similar risk factors for VA storm like low EF, structural heart disease and similar predictors of in-hospital mortality for VA storm.