Zheng Shuai, Lyu Jun, Han Didi, Xu Fengshuo, Li Chengzhuo, Yang Rui, Yao Lu, Wu Yuntao, Tian Guoxiang
Department of Geriatric Medicine, Seventh Medical Center of Chinese PLA General Hospital, Beijing, China.
School of Public Health, Shannxi University of Chinese Medicine, Xianyang, Shaanxi Province, China.
J Int Med Res. 2021 May;49(5):3000605211011976. doi: 10.1177/03000605211011976.
This study aimed to identify the prognostic factors of patients with first-time acute myocardial infarction (AMI) and to establish a nomogram for prognostic modeling.
We studied 985 patients with first-time AMI using data from the Multi-parameter Intelligent Monitoring for Intensive Care database and extracted their demographic data. Cox proportional hazards regression was used to examine outcome-related variables. We also tested a new predictive model that includes the Sequential Organ Failure Assessment (SOFA) score and compared it with the SOFA-only model.
An older age, higher SOFA score, and higher Acute Physiology III score were risk factors for the prognosis of AMI. The risk of further cardiovascular events was 1.54-fold higher in women than in men. Patients in the cardiac surgery intensive care unit had a better prognosis than those in the coronary heart disease intensive care unit. Pressurized drug use was a protective factor and the risk of further cardiovascular events was 1.36-fold higher in nonusers.
The prognosis of AMI is affected by age, the SOFA score, the Acute Physiology III score, sex, admission location, type of care unit, and vasopressin use. Our new predictive model for AMI has better performance than the SOFA model alone.
本研究旨在确定首次急性心肌梗死（AMI）患者的预后因素，并建立用于预后建模的列线图。
我们使用重症监护多参数智能监测数据库的数据研究了985例首次AMI患者，并提取了他们的人口统计学数据。采用Cox比例风险回归分析与预后相关的变量。我们还测试了一种新的预测模型，该模型包含序贯器官衰竭评估（SOFA）评分，并将其与仅使用SOFA评分的模型进行比较。
年龄较大、SOFA评分较高和急性生理学III评分较高是AMI预后的危险因素。女性发生进一步心血管事件的风险比男性高1.54倍。心脏外科重症监护病房的患者预后优于冠心病重症监护病房的患者。使用升压药是一个保护因素，未使用者发生进一步心血管事件的风险高1.36倍。
AMI的预后受年龄、SOFA评分、急性生理学III评分、性别、入院地点、监护病房类型和血管加压素使用情况的影响。我们新的AMI预测模型比单独的SOFA模型具有更好的性能。
