Age-related in-hospital mortality among patients with acute myocardial infarction.

OBJECTIVE

To evaluate the in-hospital mortality of acute myocardial infarction among different age groups.

DESIGN

Descriptive study.

PLACE AND DURATION OF STUDY

Coronary Care Unit and Cardiology Ward of Nishtar Hospital, Multan from 1st of September 2002 till 10th of April 2003.

SUBJECTS AND METHODS

The subjects were 460 admitted patients of acute myocardial infarction who fulfilled our inclusion criteria. Patients were divided into four age groups. Group-I included patients in 20-40 years, group-II (41-50 years), group-III (51-60 years) and group-IV (>60 years). Mortality was compared between different age groups by Chi-square and linear-regression models.

RESULTS

The total in-hospital mortality was 16.7%. It gradually increased from 5.6% in group-I (20-40 years) patients to 21% in group-IV (>60 years) patients. While mortality in groups group-II (41-50 years) and group-III (51-60 years) patients was 16.7% and 18.6% respectively. A marked increase in mortality was noted with increase in age. Group-IV (>60 years) patients presented 2 hours late to the hospital than the group-I (20-40 years) patients. There was no statistical difference in site of infarction in different age groups. Old age (group-IV i.e. >60 years old) was more associated with heart failure (higher Killip class) on presentation. Lesser number of patients in group-IV received thrombolytic therapy than group-I. Only 31.09% patients in group-IV and 62.5% patients in group-I received streptokinase therapy respectively.

CONCLUSION

In patients with acute myocardial infarction age was a powerful independent predictor of in-hospital mortality and complications.