Dutoit A, Mahieu G, Petit A, Cabaret P, Jacquemart T, Rihani R, Graux P, Cornaert P, Croccel L
Centre Hospitalier Saint-Philibert, Lomme, Faculté Libre de Médecine de Lille.
Ann Cardiol Angeiol (Paris). 1990 Sep;39(7):403-9.
109 subjects aged 70 years (58 women, 51 men; average age 77 years) were hospitalized in the CICU (Cardiology Intensive Care Unit) over the period stretching from 1984 to 1986. The average length of stay in the CICU was 1 week, completed by an average stay of 5 days in the cardiology department. 100 per cent of the patients were followed up. Of the clinical parameters made evident by this study, the authors note that hypertension was the predominant risk factor (52.2 per cent); a history of coronary disease was noted in 60.5 per cent; 26.6 per cent of the patients were hospitalized before the 6th hour, chest pain being typical in 78 per cent versus painless in 11 per cent of patients; topographically, the infarction was anterior in 55 per cent, posterior in 40.4 per cent, and around the circumference in 4.6 per cent of cases; 80.8 per cent of the infarctions were transmural versus 19.2 per cent of infarctions without the Q wave--the latter accounted for a higher hospital mortality rate (38 per cent versus 27.3 per cent). The main complications were disturbances in rhythm (60.6 per cent) and LVI (56.9 per cent). Complications on the form of infections were noted in 15.6 per cent. Apart from the usual indicators of severity (cardiogenic shock, VF, LVI), infarction of the RV and AF had a serious effect on the prognosis. latrogenic disease accounted for 18.9 per cent. From the point of view of prognosis, hospital mortality was 30 per cent; mortality after one year was 44 per cent and 47.7 per cent after 2 years (in a group of 76 subjects).(ABSTRACT TRUNCATED AT 250 WORDS)
1984年至1986年期间,109名70岁的受试者(58名女性,51名男性;平均年龄77岁)入住心脏重症监护病房(CICU)。在CICU的平均住院时间为1周,之后在心脏科平均住院5天。对所有患者进行了100%的随访。作者指出,在本研究揭示的临床参数中,高血压是主要危险因素(52.2%);60.5%的患者有冠心病史;26.6%的患者在发病后6小时内入院,78%的患者胸痛典型,11%的患者无痛;从梗死部位来看,55%为前壁梗死,40.4%为后壁梗死,4.6%为环周梗死;80.8%的梗死为透壁性,19.2%为无Q波梗死,后者的医院死亡率更高(38%对27.3%)。主要并发症为心律失常(60.6%)和左心室功能不全(56.9%)。15.6%的患者出现感染性并发症。除了常见的严重程度指标(心源性休克、室颤、左心室功能不全)外,右心室梗死和房颤对预后有严重影响。医源性疾病占18.9%。从预后角度看,医院死亡率为30%;1年后死亡率为44%,2年后为47.7%(76名受试者组成的一组)。(摘要截选至250词)