老年冠心病监护病房患者的短期预后：MORCOR-TURK（土耳其冠心病监护病房死亡率和发病率研究）试验的亚组分析。

Short-Term Prognosis of Elderly Patients Admitted to the Coronary Care Unit: A Subgroup Analysis of the MORCOR-TURK (Mortality and Morbidity in Coronary Care Units in Türkiye) Trial.

机构信息

Department of Cardiology, Trakya University Faculty of Medicine, Edirne, Türkiye.

Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Türkiye.

出版信息

Turk Kardiyol Dern Ars. 2024 Sep;52(6):411-419. doi: 10.5543/tkda.2024.51282.

DOI:10.5543/tkda.2024.51282

PMID:39225647

Abstract

OBJECTIVE

This subgroup analysis of the MORCOR-TURK (Mortality and Morbidity in Coronary Care Units in Türkiye) trial aimed to determine the short-term prognosis, mortality rates, and predictors for elderly patients followed in coronary care units (CCUs) in Türkiye.

METHODS

The MORCOR-TURK trial is a national, non-interventional, multicenter observational study conducted in Türkiye (ClinicalTrials.gov number NCT05296694). The study population includes CCU patients from 50 centers selected from all regions of Türkiye (between September 1 and 30, 2022 prospectively). In the subgroup analysis, patients were divided into two groups: Group 1 (ages 65 to < 75 years, n = 923 patients) and Group 2 (ages ≥ 75 years, n = 713 patients). At the end of the analysis, short-term prognosis, mortality rates, and predictors were documented.

RESULTS

The mean age of Group 1 was 69 (67-72) years, and Group 2 was 80 (77-84) years. Chest pain was the most common reason for admission (968 patients [59.16%]), and acute coronary syndrome was the most common reason for hospitalization in the CCU (1,053 patients [64%]). Atrial fibrillation (AF) was the most common arrhythmia (356 patients [21.76%]). The mortality rate was 6.11% in elderly patients (4.23% in Group 1 and 8.56% in Group 2). The multivariate regression analysis showed that age (P = 0.046, P = 0.003), chronic kidney disease (P = 0.011, P = 0.045), and ventricular tachycardia/ventricular fibrillation (VT/VF) during hospitalization (P < 0.001) were the main factors that increased mortality in both groups. Other independent mortality risk factors were smoking for Group 1 and aortic stenosis for Group 2.

CONCLUSION

This study represents the most comprehensive assessment of the short-term prognosis for elderly patients admitted to CCUs in Türkiye. It showed that coronary artery disease was the most common reason for admission and age over 75 and chronic kidney disease were the main determinants of mortality.

摘要

目的

本研究是 MORCOR-TURK（土耳其冠心病监护病房的死亡率和发病率）试验的亚组分析，旨在确定在土耳其冠心病监护病房（CCU）接受治疗的老年患者的短期预后、死亡率和预测因素。

方法

MORCOR-TURK 试验是一项全国性、非干预性、多中心观察性研究，在土耳其进行（ClinicalTrials.gov 编号 NCT05296694）。该研究人群包括从土耳其各地的 50 个中心选择的 50 个中心的 CCU 患者（2022 年 9 月 1 日至 30 日前瞻性纳入）。在亚组分析中，患者被分为两组：第 1 组（年龄 65 岁至<75 岁，n=923 例）和第 2 组（年龄≥75 岁，n=713 例）。在分析结束时，记录了短期预后、死亡率和预测因素。

结果

第 1 组的平均年龄为 69（67-72）岁，第 2 组为 80（77-84）岁。胸痛是最常见的入院原因（968 例[59.16%]），急性冠状动脉综合征是 CCU 最常见的住院原因（1053 例[64%]）。最常见的心律失常是心房颤动（AF）（356 例[21.76%]）。老年患者的死亡率为 6.11%（第 1 组为 4.23%，第 2 组为 8.56%）。多变量回归分析显示，年龄（P=0.046，P=0.003）、慢性肾脏病（P=0.011，P=0.045）和住院期间室性心动过速/心室颤动（VT/VF）（P<0.001）是两组患者死亡的主要因素。其他独立的死亡风险因素为第 1 组的吸烟和第 2 组的主动脉瓣狭窄。