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考虑治疗过程的后勤方面,评估心肌梗死患者的院内死亡率及其危险因素:一项单中心回顾性观察研究。

Assessment of In-Hospital Mortality and Its Risk Factors in Patients with Myocardial Infarction Considering the Logistical Aspects of the Treatment Process-A Single-Center, Retrospective, Observational Study.

机构信息

Department of Management and Logistics in Health Care, Medical University of Lodz, 90-237 Lodz, Poland.

Department of Epidemiology and Biostatistics, Medical University of Lodz, 90-237 Lodz, Poland.

出版信息

Int J Environ Res Public Health. 2023 Feb 17;20(4):3603. doi: 10.3390/ijerph20043603.

Abstract

Technological progress, such as the launching of a new generation of drug-coated stents as well as new antiplatelet drugs, has resulted in the treatment of myocardial infarction (MI) becoming much more effective. The aim of this study was to assess in-hospital mortality and to conduct an assessment of risk factors relevant to the in-hospital death of patients with MI. This study was based on an observational hospital registry of patients with MI (ACS GRU registry). For the purpose of the statistical analysis of the risk factors of death, a univariate logistic regression model was applied. In-hospital general mortality amounted to 7.27%. A higher death risk was confirmed in the following cases: (1) serious adverse events (SAEs) that occurred during the procedure; (2) patients transferred from another department of a hospital (OR = 2.647, = 0.0056); (3) primary percutaneous coronary angioplasty performed on weekdays between 10 p.m. and 8 a.m. (OR = 2.540, = 0.0146). The influence of workload and operator experience on the risk of death in a patient with MI has not been confirmed. The results of this study indicate the increasing importance of new risk factors for in-hospital death in patients with MI, such as selected logistical aspects of the MI treatment process and individual SAEs.

摘要

技术进步,如新一代药物涂层支架和新型抗血小板药物的推出,使得心肌梗死(MI)的治疗效果大大提高。本研究旨在评估住院死亡率,并评估与 MI 患者住院死亡相关的危险因素。本研究基于 MI(ACS GRU 登记处)患者的观察性医院登记处。为了对死亡危险因素进行统计分析,应用了单变量逻辑回归模型。住院总死亡率为 7.27%。以下情况确认了更高的死亡风险:(1) 手术过程中发生的严重不良事件(SAE);(2) 从医院其他科室转来的患者(OR = 2.647, = 0.0056);(3) 工作日晚上 10 点至早上 8 点进行的直接经皮冠状动脉介入治疗(OR = 2.540, = 0.0146)。工作量和操作人员经验对 MI 患者死亡风险的影响尚未得到证实。本研究结果表明,对于 MI 患者住院死亡的新危险因素的重要性不断增加,例如 MI 治疗过程中选择的特定后勤方面和个别 SAE。

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