Bradycardia in Older Patients in a Single-Center Emergency Department: Incidence, Characteristics and Outcomes

Figures & data

Table 1 Baseline Characteristics of Patients with Symptomatic Bradycardia

Patient Characteristic	N = 205 (%)
Female	114 (55.70)
Age, mean (±SD)	74.9 (±9)
Underlying disease
Hypertension	165 (80.51)
Dyslipidemia	100 (48.82)
Cardiovascular disease	76 (37.11)
Diabetes mellitus	76 (37.00)
Cerebrovascular disease	26 (12.74)
Congestive heart failure	16 (7.81)
Thyroid disease	15 (7.31)
End-stage renal disease with dialysis	9 (4.41)
Valvular heart disease	7 (3.51)
Systolic dysfunction (left ventricular ejection fraction <40%)	6 (2.93)
Chronic obstructive pulmonary disease	4 (2.00)
Pericarditis	1 (0.51)
Smoking	10 (4.94)
Alcohol drinking	7 (3.41%)

Table 2 Symptoms of Unstable Bradycardia and ECG Before Treatment

Unstable Bradycardia, n=32 (%)
Symptoms
Dyspnea	10 (31.26)
Chest pain	6 (18.75)
Altered mental status	6 (18.75)
Syncope	4 (12.50)
Hypotension	3 (9.38)
Palpitation	3 (9.38)
Electrocardiogram
Sinus bradycardia	13 (39.40)
Third-degree atrioventricular block	9 (27.20)
Junctional rhythm	6 (18.20)
Atrial fibrillation slow rate	4 (12.50)

Table 3 Medications Used in Symptomatic Bradycardia Patients

Name	Stable, n = 173 (%)	Unstable, n = 32 (%)	P value
Diuretic	47 (27.17)	12 (37.50)	0.24
Angiotensin-converting enzyme inhibitor	13 (7.51)	1 (3.12)	0.37
Angiotensin II receptor blocker	51 (31.21)	11 (34.38)	0.72
Calcium channel blocker	46 (26.59)	9 (28.12)	0.86
Beta-blocker	88 (50.87)	14 (43.75)	0.46
Digoxin	5 (2.89)	0	1.00
Amiodarone	5 (2.89)	0	1.00

Table 4 Outcomes at 30 and 180 Days After Emergency Department Disposition n=205 Patients

Variable	30 Days, n (%)	180 Days, n (%)
Mortality rate	13 (6.34)	16 (7.80)
Emergency department revisited	26 (12.68)	32 (15.61)
Subsequence hospitalizations	5 (2.44)	5 (2.44)
Composite outcomes	39 (19.02)	45 (21.95)

Table 5 Factors Associated with Adverse Outcomes (Composite Outcomes) at 30 Days

	Total N = 205 (%)	Adverse Events 30 Days N = 39 (%)	P value	Multiple Logistic Regression Odds Ratio (95% CI)
Gender, female	114 (55.61)	24 (61.54)	0.41
Medication
Diuretic	59 (28.78)	10 (25.64)	0.63
Angiotensin-converting enzyme inhibitor	14 (6.82)	2 (5.13)	1
Angiotensin II receptor blocker	65 (31.70)	16 (41.03)	0.17	0.59	0.58–2.77
Calcium channel blocker	63 (30.73)	11 (28.21)	0.83
Beta-blocker	102 (49.75)	20 (51.28)	0.83
Amiodarone	5 (2.43)	2 (5.13)	0.24
Digoxin	5 (2.43)	0	1
Comorbidity
Cardiovascular disease	76 (37.07)	18 (46.15)	0.19	0.68	0.61–2.78
Hypertension	165 (80.48)	35 (89.74)	0.12	0.88	0.52–5.51
Dyslipidemia	100 (48.78)	21 (53.85)	0.48
Diabetes mellitus	76 (37.07)	17 (43.59)	0.35
Heart failure	16 (7.80)	4 (10.26)	0.51
Left ventricular ejection fraction <40%	6 (2.92)	2 (5.13)	0.37
Pericarditis	1 (0.48)	0	1
Valvular heart disease	7 (3.41)	1 (2.56)	1
Cerebrovascular disease	26 (12.68)	5 (12.82)	0.98
Chronic obstructive pulmonary disease	4 (1.95)	0	1
End-stage renal disease with dialysis	9 (4.39)	5 (12.82)	0.01	2.34	1.31–20.88
Thyroid disease	15 (7.31)	5 (12.82)	0.14	1.11	0.60–6.34
Alcohol	7 (3.41)	1 (2.56)	1
Smoking	10 (4.87)	3 (7.69)	0.41