Younis Hadia, Loh Chia Chi, Singh Charanjot, Pichuthirumalai Srikrishnan, Kaur Gagan, Bajwa Avreet S, Aziz Syed Nurul, Vasavada Advait, Patel Viralkumar
Department of Medicine, Peshawar Medical College, Peshawar, Pakistan.
Department of Internal Medicine, Manipal University College Malaysia, Melaka, Malaysia.
SN Compr Clin Med. 2023;5(1):160. doi: 10.1007/s42399-023-01499-9. Epub 2023 Jun 7.
The objective is to study factors that increase the likelihood of acute myocardial infarction (AMI) in hospitalized adult non-elderly patients with pneumonia compared to other medical inpatients and to understand the utilization rate of percutaneous coronary intervention (PCI) for AMI in inpatients with pneumonia and its related impact on hospitalization stay and cost. A population-based study was conducted using the Nationwide Inpatient Sample (NIS, 2019) with adult non-elderly inpatients (age 18-65 years) with a medical condition as their primary diagnosis and a co-diagnosis of pneumonia during hospitalization stay. This study sample was divided by the primary diagnosis of AMI versus other medical conditions (non-AMI). A logistic regression model was used to evaluate the odds ratio (OR) of predictors associated with AMI in patients with pneumonia. The results showed a direct relationship between increasing age and the likelihood of AMI in pneumonia inpatients with three times higher odds seen in 51-65 years of age (OR 2.95, 95% CI 2.82-3.09). The comorbidities included complicated hypertension (OR 2.84, 95% CI 2.78-2.89), diabetes with complications (OR 1.27, 95% CI 1.24-1.29), and drug abuse (OR 1.27, 95% CI 1.22-1.31) that increased the likelihood of AMI-related hospitalization. The utilization rate of surgical treatment (PCI) was 14.37% for the management of AMI in inpatients with pneumonia. Inpatients co-diagnosed with pneumonia and comorbidities such as hypertension and diabetes were more likely to be hospitalized for AMI. These at-risk patients should be considered for early risk stratification. Utilization of PCI was associated with a lower in-hospital mortality rate.
目的是研究与其他内科住院患者相比,住院的成年非老年肺炎患者发生急性心肌梗死(AMI)可能性增加的因素,并了解肺炎住院患者中AMI的经皮冠状动脉介入治疗(PCI)利用率及其对住院时间和费用的相关影响。使用全国住院患者样本(NIS,2019)进行了一项基于人群的研究,研究对象为以内科疾病作为主要诊断且在住院期间合并肺炎诊断的成年非老年住院患者(年龄18 - 65岁)。本研究样本根据AMI的主要诊断与其他内科疾病(非AMI)进行划分。采用逻辑回归模型评估肺炎患者中与AMI相关预测因素的比值比(OR)。结果显示,年龄增加与肺炎住院患者发生AMI的可能性之间存在直接关系,51 - 65岁患者发生AMI的几率高出三倍(OR 2.95,95% CI 2.82 - 3.09)。合并症包括复杂性高血压(OR 2.84,95% CI 2.78 - 2.89)、糖尿病伴并发症(OR 1.27,95% CI 1.24 - 1.29)和药物滥用(OR 1.27,95% CI 1.22 - 1.31),这些因素增加了与AMI相关住院的可能性。肺炎住院患者中AMI的手术治疗(PCI)利用率为14.37%。合并肺炎以及高血压和糖尿病等合并症的住院患者更有可能因AMI住院。这些高危患者应考虑进行早期风险分层。PCI的使用与较低的院内死亡率相关。