Chau-In Waraporn, Chanthawong Sarinya, Pipanmekaporn Tanyong, Kongsayreepong Suneerat, Chittawatanarat Kaweesak, Rojanapithayakorn Nonthida
J Med Assoc Thai. 2016 Sep;99 Suppl 6:S74-S82.
To describe the incidence, characteristics and outcomes of acute myocardial infarction (AMI) and determine risk factor(s) of AMI in THAI-surgical intensive care unit (SICU).
This study was multicenter prospective cohorts study that conducted data from 9 university-affiliated SICUs in Thailand between April 2011 and January 2013. We collected and evaluated data of AMI events. The patients were followed-up for up to 28 days after admitted to the SICUs.
The overall incidence of AMI in SICU was 1.4% (66 of 4,652 patients). Non-ST elevated MI was the most common electrocardiography (ECG) presentation (75%). The common clinical sign and symptom of AMI included ECG changes (53%) and elevation of cardiac enzymes (48.5%). Patients with AMI had significantly higher 28-day mortality rate (28.8% versus 13.6%, p<0.001) than those with non-MI. The Acute Physiologic and Chronic Health Evaluation (APACHE) II scores (RR 1.04, 95% CI 1.01-1.07, p = 0.003) and age >65 year (RR 2.54, 95% CI 1.36-4.75, p = 0.003) were significant risk factors of AMI.
The incidence of AMI in the SICU was uncommon but led to significantly higher mortality rates. The APACHE II score and age ≥65 year were significant predictors of AMI in SICU.
描述急性心肌梗死(AMI)的发病率、特征和结局,并确定泰国外科重症监护病房(SICU)中AMI的危险因素。
本研究为多中心前瞻性队列研究,收集了2011年4月至2013年1月期间泰国9家大学附属医院SICU的数据。我们收集并评估了AMI事件的数据。患者入住SICU后随访长达28天。
SICU中AMI的总体发病率为1.4%(4652例患者中的66例)。非ST段抬高型心肌梗死是最常见的心电图(ECG)表现(75%)。AMI的常见临床体征和症状包括ECG改变(53%)和心肌酶升高(48.5%)。AMI患者的28天死亡率(28.8%对13.6%,p<0.001)显著高于非AMI患者。急性生理与慢性健康状况评估(APACHE)II评分(RR 1.04,95%CI 1.01 - 1.07,p = 0.003)和年龄>65岁(RR 2.54,95%CI 1.36 - 4.75,p = 0.003)是AMI的显著危险因素。
SICU中AMI的发病率不高,但导致显著更高的死亡率。APACHE II评分和年龄≥65岁是SICU中AMI的显著预测因素。