Nicolas G, Bouhour J B, Godin J F, Rozo L, Lefevre M, Helias J
Arch Mal Coeur Vaiss. 1982 Sep;75(9):981-8.
The complications of myocardial infarction after transfer from the Coronary Care Unit on the 6th day were analysed bu a retrospective study of 3,460 computerised case reports (1973-1980). The mortality rate was 6% (1/3 of hospital deaths) in the period from the 7th day to discharge from hospital (14th to 30th day). Cardiac arrest as not uncommon (20% of all cardiac arrests) but the prognosis was better thn during the initial phase (p less than 0.05) as the mechanism was more commonly ventricular fibrillation or tachycardia (p less than 0.05). This series was compared with a similar population from 1970-1973; an improvement was observed in global hospital mortality (27% previously compared to 17%, in the study series, p less than 0.001). As the population were comparable, this phenomenon seems to be related to better treatment of shock and cardiac failure and the advances in cardiac surgery during the initial phase of infarction. Thd commonest mechanical complication was ventricular aneurysm; its occurrence does not influence the vital prognosis during this period. The incidence of cardiac arrest and death due to cardiac failure is not negligible after the first week of myocardial infarction. Therefore, we do not believe that the hospital period should be reduced after myocardial infarction. Special training of the nursing staff is essential for the successful treatment of these complications. The global prognosis could be improved by the rehabilitation of digitalis therapy and the introduction of new sympathomimetic amines in the acute phase of myocardial infarction.
通过对3460份计算机化病例报告（1973 - 1980年）进行回顾性研究，分析了在第6天从冠心病监护病房转出后心肌梗死的并发症。从第7天到出院（第14天至30天）期间的死亡率为6%（占医院死亡人数的1/3）。心脏骤停并不少见（占所有心脏骤停的20%），但其预后比初始阶段要好（p小于0.05），因为其机制更常见为心室颤动或心动过速（p小于0.05）。该系列与1970 - 1973年的类似人群进行了比较；观察到总体医院死亡率有所改善（之前为27%，研究系列中为17%，p小于0.001）。由于人群具有可比性，这种现象似乎与休克和心力衰竭的更好治疗以及梗死初始阶段心脏手术的进展有关。最常见的机械并发症是室壁瘤；其发生在此期间不影响生命预后。心肌梗死后第一周后，心脏骤停和因心力衰竭导致的死亡发生率不可忽视。因此，我们认为心肌梗死后的住院时间不应缩短。护理人员的专门培训对于成功治疗这些并发症至关重要。通过恢复洋地黄疗法以及在心肌梗死急性期引入新的拟交感神经胺，可以改善总体预后。
