Ribeiro Demóstenes Gonçalves Lima, de Andrade Pedro José Negreiros, Paes J nior José Nogueira, Saraiva Lurildo Ribeiro
Hospital de Messejana, Secretaria de Saúde do Estado do Cearé, Recife, PE, Brazil.
Arq Bras Cardiol. 2003 Jun;80(6):614-20, 607-13. doi: 10.1590/s0066-782x2003000600004. Epub 2003 Jul 2.
To identify the clinical and demographic predictors of in-hospital mortality in acute myocardial infarction with elevation of the ST segment in a public hospital, in the city of Fortaleza, Ceará state, Brazil.
A retrospective study of 373 patients experiencing their first episode of acute myocardial infarction was carried out. Of the study patients, 289 were discharged from the hospital (group A) and 84 died (group B). Both groups were analyzed regarding: sex; age; time elapsed from the beginning of the symptoms of myocardial infarction to assistance at the hospital; use of streptokinase; risk factors for atherosclerosis; electrocardiographic location of myocardial infarct; and Killip functional class.
In a univariate analysis, group B had a greater proportion of the following parameters as compared with group A: non-Killip I functional class; diabetes; age >70 years; infarction of the inferior wall associated with right ventricular impairment; time between symptom onset and treatment at the hospital >12 h; anteroseptal or extensive anterior infarction; no use of streptokinase; and no tobacco use. In a multivariate logistic regression analysis, only non-Killip I functional class, diabetes, and age >70 years persisted as independent factors for death.
Non-Killip I functional class, diabetes, and age >70 years were independent predictors of mortality in acute myocardial infarction with elevation of the ST segment.
在巴西塞阿拉州福塔莱萨市的一家公立医院，确定ST段抬高型急性心肌梗死患者院内死亡的临床和人口统计学预测因素。
对373例首次发生急性心肌梗死的患者进行回顾性研究。研究患者中，289例出院（A组），84例死亡（B组）。对两组患者的以下方面进行分析：性别；年龄；从心肌梗死症状开始到医院就诊的时间；链激酶的使用；动脉粥样硬化危险因素；心肌梗死的心电图定位；以及Killip心功能分级。
在单因素分析中，与A组相比，B组在以下参数方面的比例更高：非Killip I级心功能分级；糖尿病；年龄>70岁；下壁梗死合并右心室功能障碍；症状发作与医院治疗之间的时间>12小时；前间隔或广泛前壁梗死；未使用链激酶；以及不吸烟。在多因素逻辑回归分析中，只有非Killip I级心功能分级、糖尿病和年龄>70岁仍然是死亡的独立因素。
非Killip I级心功能分级、糖尿病和年龄>70岁是ST段抬高型急性心肌梗死患者死亡的独立预测因素。
