Karlson B W, Herlitz J, Hallgren P, Liljeqvist J A, Odén A, Hjalmarson A
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Eur Heart J. 1994 Nov;15(11):1558-65. doi: 10.1093/oxfordjournals.eurheartj.a060430.
This study aims at describing the in-hospital prognosis of patients admitted with suspected acute myocardial infarction, focusing on the possibility of emergency room prediction of the risk for death and severe complications. From 7157 consecutive patients with chest pain or other symptoms suggestive of acute myocardial infarction in the emergency room, 4690 were hospitalized. Of these, 246 (5%) died in hospital, with a mortality rate among the 921 patients who developed myocardial infarction of 14%, and among those without infarction of 3%. From the clinical history, examination and electrocardiogram in the emergency room, independent predictors of death and death or any severe complication were determined by logistic regression analysis. These included age, initial degree of suspicion of infarction, electrocardiographic pattern, history of diabetes mellitus, history of congestive heart failure and on admission arrhythmias, loss of consciousness, acute congestive heart failure, or unspecific symptoms. From these analyses the probability of death or death or any severe complication can be calculated. Thus, 18% of patients hospitalized due to suspected acute myocardial infarction suffered a severe complication or died in hospital. From a statistical model it is possible to predict the in-hospital prognosis of every such patient.
本研究旨在描述疑似急性心肌梗死入院患者的院内预后情况，重点关注急诊室预测死亡和严重并发症风险的可能性。在急诊室连续7157例有胸痛或其他提示急性心肌梗死症状的患者中，4690例住院治疗。其中，246例（5%）在医院死亡，在发生心肌梗死的921例患者中死亡率为14%，未发生梗死的患者中死亡率为3%。通过逻辑回归分析，根据急诊室的临床病史、检查和心电图，确定了死亡以及死亡或任何严重并发症的独立预测因素。这些因素包括年龄、最初对梗死的怀疑程度、心电图模式、糖尿病史、充血性心力衰竭史以及入院时的心律失常、意识丧失、急性充血性心力衰竭或非特异性症状。通过这些分析，可以计算出死亡或死亡或任何严重并发症的概率。因此，因疑似急性心肌梗死住院的患者中有18%发生了严重并发症或在医院死亡。从统计模型可以预测每例此类患者的院内预后。
