In-hospital death of acute myocardial infarction patients and the influencing factors: A retrospective analysis / 第二军医大学学报

ABSTRACT

Objective To investigate the causes of in-hospital death of acute myocardial infarction(AMI) patients and to analyze the independent predictors of the death. Methods We retrospectively analyzed the clinical data of 1 319 AMI patients who were treated from December 2006 to January 2012 in our hospital, and the data included the general condition, medical history and family history, admission examination, clinical diagnosis, complication, treatment and in-hospital death and the reasons. Results (l)The in-hospital mortality rate of AMI patients was 7. 4% in the past five years in our hospital, with the rate of female being significantly higher than that of males (13. 2% vs 5. 9%,P = 0. 000), with those who received no operation being significant higher than those received (31. 4% vs 3. 4%,P = 0. 000), and with those received emergent operation being significantly higher than those received selective operation (5. 0% vs 2. 2%,P = 0. 008). The incidence rate of cardiogenic shock was 10. 6% in patients with AMI, and they had an in-hospital death rate of 47. 1%, with those received no operation being significantly higher than those received emergent and selective operation (80. 4% vs 34. 5%, 17. 6%, P = 0. 000). (2)The in-hospital death (controlling gender) was positively associated with age, urea acid, blood urea nitrogen, creatinine, cystatin C, glucose, white blood cell, peak concentration of troponin, B-type natriuretic peptide (BNP), presence of arrhythmia, cardiogenic shock, Killip 3-4 group, placement of intraaortic balloon pump (IABP), and receiving no operation, and was negatively associated with red blood cell, hemoglobin, hematocrit, and use of drugs. (3)Independent risk factors of in-hospital death of AMI patients include d female sex, older age, high level of blood urea nitrogen, glucose, peak concentration of troponin and BNP, presence of arrhythmia, cardiogenic shoe k, Killip 3-4 group, receiving no operation, placement of IABP, and receiving no drugs. Conclusion Prompt reperfusion is the best treatment choice for AMI patients, especially for those presenting with cardiogenic shock. More emphasis should be given to predictors of in-hospital mortality, such as age, blood urea nitrogen, glucose, peak concentration of troponin and BNP; also cystatin C should be examined for more patients with AMI in clinic.