Herlitz J, Karlson B W, Lindqvist J, Sjölin M
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
J Intern Med. 1998 Jan;243(1):41-8. doi: 10.1046/j.1365-2796.1998.00244.x.
To describe the mortality and mode of death over 5 years, and factors associated with death amongst patients with acute chest pain.
All patients who came to the emergency department at Sahlgrenska Hospital in Göteborg with acute chest pain or other symptoms raising suspicion of acute myocardial infarction (AMI) during a 21-month period.
In all, 5241 patients were evaluated, of whom 1345 (26%) died during the 5 years of follow-up. The following factors were independent predictors male sex (P < 0.001); symptoms of acute congestive heart failure (P < 0.001) or unspecific symptoms on admission (P < 0.05); smoking (P < 0.001); a history of either congestive heart failure (P < 0.001), diabetes mellitus (P < 0.001), previous myocardial infarction (P < 0.001) or hypertension (P < 0.05); initial degree of suspicion of AMI (P < 0.001) and presence of pathological electrocardiogram (P < 0.001) on admission to hospital. Amongst patients who died, 66% died a cardiac death and 35% died in association with a myocardial infarction.
Amongst patients admitted to the emergency department due to chest pain or other symptoms raising suspicion of AMI, several predictors based on clinical history and clinical presentation can be defined, which are strongly related to the long-term prognosis.
描述5年期间的死亡率和死亡方式，以及急性胸痛患者的死亡相关因素。
在21个月期间因急性胸痛或其他引发急性心肌梗死（AMI）怀疑症状前来哥德堡萨尔格伦斯卡医院急诊科就诊的所有患者。
总共评估了5241例患者，其中1345例（26%）在5年随访期间死亡。以下因素是独立预测因素：男性（P<0.001）；急性充血性心力衰竭症状（P<0.001）或入院时非特异性症状（P<0.05）；吸烟（P<0.001）；充血性心力衰竭病史（P<0.001）、糖尿病病史（P<0.001）、既往心肌梗死病史（P<0.001）或高血压病史（P<0.05）；对AMI的初始怀疑程度（P<0.001）以及入院时病理性心电图的存在（P<0.001）。在死亡患者中，66%死于心源性死亡，35%死于与心肌梗死相关的死亡。
在因胸痛或其他引发AMI怀疑症状而入住急诊科的患者中，可以确定几个基于临床病史和临床表现的预测因素，这些因素与长期预后密切相关。
