[心肌梗死编码程序单中心注册研究分析：回顾性队列研究]

[Analysis of the unicentric registry of the Infarction Code program: retrospective cohort].

作者信息

Toledo-Salinas Otoniel, Gómez-Flores Saira Sanjuana, García-Hernández Ernesto, Armenta-Pérez Verónica, García-Rincón Andrés

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Unidad de Cuidados Intensivos. Ciudad de México, México.

Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Unidad de Cuidados Coronarios. Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2024 Jan 8;62(1):1-8. doi: 10.5281/zenodo.10278115.

DOI:10.5281/zenodo.10278115

PMID:39106526

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12094798/

Abstract

BACKGROUND

Acute coronary syndrome (ACS) is the most serious manifestation of coronary heart disease. The Infarction Code (according to its initialism in Spanish, CI: Código Infarto) program aims to improve the care of these patients.

OBJECTIVE

To describe the clinical presentation and outcomes of CI program in a coronary care unit (CCU).

MATERIAL AND METHODS

A database of a CCU with 5 years of consecutive records was analyzed. Patients diagnosed with ACS were included. The groups with acute myocardial infarction with and without ST-segment elevation were compared using Student's t, Mann-Whitney U and chi-squared tests. We calculated the relative risk (RR) and 95% confidence intervals (95% CI) of cardiovascular risk factors for mortality.

RESULTS

A total of 4678 subjects were analyzed, 78.7% men, mean age 63 years (± 10.7). 80.76% presented acute myocardial infarction with positive ST-segment elevation and fibrinolytic was granted in 60.8% of cases. Percutaneous coronary intervention was performed in 81.4% of patients, which was successful in 82.5% of events. Patients classified as CI presented mortality of 6.8% vs. 11.7%, p = 0.001. Invasive mechanical ventilation had an RR of 26.58 (95% CI: 20.61-34.3) and circulatory shock an RR of 20.86 (95% CI: 16.16-26.93).

CONCLUSIONS

The CI program decreased mortality by 4.9%. Early fibrinolysis and successful coronary angiography are protective factors for mortality within CCU.

摘要

背景

急性冠状动脉综合征（ACS）是冠心病最严重的表现形式。梗死编码（根据其西班牙语首字母缩写，CI：Código Infarto）项目旨在改善这些患者的护理。

目的

描述冠心病监护病房（CCU）中梗死编码项目的临床表现及结局。

材料与方法

分析一个拥有连续5年记录的CCU数据库。纳入诊断为ACS的患者。使用学生t检验、曼-惠特尼U检验和卡方检验比较伴有和不伴有ST段抬高的急性心肌梗死组。我们计算了心血管危险因素导致死亡的相对风险（RR）和95%置信区间（95%CI）。

结果

共分析了4678名受试者，男性占78.7%，平均年龄63岁（±10.7）。80.76%表现为ST段抬高阳性的急性心肌梗死，60.8%的病例给予了溶栓治疗。81.4%的患者接受了经皮冠状动脉介入治疗，其中82.5%的手术成功。归类为梗死编码的患者死亡率为6.8%，而其他患者为11.7%，p = 0.001。有创机械通气的RR为26.58（95%CI：20.61 - 34.3），循环休克的RR为20.86（95%CI：16.16 - 26.93）。