社会人口学和临床变量作为亚马逊东部急性ST段抬高型心肌梗死患者死亡率和生存率的决定因素

Sociodemographic and clinical variables as determinants of mortality and survival in patients with acute ST-elevation myocardial infarction in the Eastern Amazon.

作者信息

Amoras Tárcio Sadraque Gomes, Mendonça Thalia Saraiva, Melo Giovana Salomão, Pereira Kleber Renato Ponzi, Zaninotto Christielaine Venzel, de Oliveira Sheila Santos, da Silva Rosana Moreira, Gomes Fabiana Campos, de Melo Neto João Simão

机构信息

Clinical and Experimental Research Unit of the Urinary and Genital System (UPCEURG), Institute of Health Sciences (ICS), Federal University of Pará (UFPA), Belém, Pará, Brazil.

Division of Cardiology, Gaspar Vianna Clinical Hospital Foundation, Belém, Pará, Brazil.

出版信息

J Public Health Res. 2023 Jan 16;12(1):22799036221150062. doi: 10.1177/22799036221150062. eCollection 2023 Jan.

DOI:10.1177/22799036221150062

PMID:36686587

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9846297/

Abstract

BACKGROUND

The aim of this study was to analyze the influence of sociodemographic and clinical variables as determinants of mortality and survival in patients with ST-segment elevation acute myocardial infarction in the Eastern Amazon.

DESIGN AND METHODS

This observational, longitudinal, and retrospective study was conducted at the Gaspar Vianna Clinical Hospital Foundation in patients hospitalized from January 2017 to June 2020. Patients were divided into two groups: those who survived (G1) ( = 646) and those who died (G2) ( = 37). Sociodemographic and clinical variables associated with mortality and survival in these two groups were analyzed.

RESULTS

Patients with STEMI who had the highest risk of death were often the oldest (G1: 61.58 ± 10.74 years; G2: 69.57 ± 9.02 years; = -4.492; = 0.001), with Killip III-IV classifications (OR = 0.13; 95% CI = 0.02-0.71; = 0.03), and with diseases such as heart failure (OR = 0.07; 95% CI = 0.004-1.50; = 0.168) or renal failure (OR = 0.03; 95% CI = 0.006-0.16; = 0.0001). In addition, female sex (hazard ratio = 2.073; 95% CI = 1.413-5.170), Killip III-IV classifications (hazard ratio = 4.041; 95% CI = 1.703-18.883) and the presence of heart failure (hazard ratio = 34.102; 95% CI = 4.410-263.684) or renal failure (hazard ratio = 14.278; 95% CI = 3.275-62.248) shortened in-hospital survival.

CONCLUSIONS

Specific sociodemographic and clinical aspects influenced mortality and survival in patients with acute ST -elevation myocardial infarction.

摘要

背景

本研究旨在分析社会人口统计学和临床变量作为亚马孙东部ST段抬高型急性心肌梗死患者死亡率和生存率决定因素的影响。

设计与方法

本观察性、纵向和回顾性研究在加斯帕尔·维亚纳临床医院基金会开展，研究对象为2017年1月至2020年6月期间住院的患者。患者分为两组：存活组（G1）（n = 646）和死亡组（G2）（n = 37）。分析了这两组中与死亡率和生存率相关的社会人口统计学和临床变量。

结果

ST段抬高型心肌梗死死亡风险最高的患者通常年龄最大（G1：61.58±10.74岁；G2：69.57±9.02岁；t = -4.492；p = 0.001），Killip III-IV分级（比值比 = 0.13；95%置信区间 = 0.02 - 0.71；p = 0.03），以及患有心力衰竭（比值比 = 0.07；95%置信区间 = 0.004 - 1.50；p = 0.168）或肾衰竭（比值比 = 0.03；95%置信区间 = 0.006 - 0.16；p = 0.0001）等疾病。此外，女性（风险比 = 2.073；95%置信区间 = 1.413 - 5.170）、Killip III-IV分级（风险比 = 4.041；95%置信区间 = 1.703 - 18.883）以及存在心力衰竭（风险比 = 34.102；95%置信区间 = 4.410 - 263.684）或肾衰竭（风险比 = 14.278；95%置信区间 = 3.275 - 62.248）会缩短住院生存期。