Clinical Characteristics And Multiplicity In Short-term Prognosis In The Hospitalized Patient With AMI

Object:The following index was collected with: age, sex, previous medical history, accompanying disease, primary symptom, vital sign, laboratory result, treatment, complication, and survival rate within 30 days in patients with AMI. The statistical results was analyzed with logistic regression. Correlation factor about survival rate within 30 days and age was selected to guide the clinical practice.Methods:1 .The patients hospitalized in Chinese PLA General Hospital from January 1993 to May 2006 with AMI was selected and the clinical records were gathered. The statistical results were entered to the EXCEL table.2.There are 1443 patients were selected, and divided into 3 groups followed the age respectively (age <65years, age 65years to 74years, age≥75years). The statistical difference of each group were analyzed as described in methods.3.The patients were grouped as cardiogenic death group( including cardiogenic shock, heart failure, ventricular fibrillation, heart rupture, cardiac arrest and sudden death) and survival group. The factors which contribute to the survival rate within 30 days were analyzed with Logistic regression.4.The patients were grouped as AMI complicated by pneumonia group and non-pneumonia group. The factors which contribute to the pneumonia were analyzed with Logistic regression.Results:1. Comparing all datas among three groups: The histories of hyperlipemia, smoking and drinking wine were higher in adult group than other groups. For gender proportion, the ratio of female was higher in the elderly or very elderlygroup than in adult group. The prevalence of hypertension, histories of diabetes, prior MI, cerebral infarction, anaemia, dyspnea, non-ST segment elevated myocardial infarction, three-vessel and left main stem coronary disease, heart failure, arrhythmia, pneumonia, total mortality and cardiogenic Death was higher in the very elderly group than other groups. However, the therapy of platelet aggregation inhibitor, β receptor blocker, angiotension-converting enzyme inhibitor, thrombolysis and PCI was lower in very elderly than those in adult and elderly groups.2. Univariate analysis indicated that age, histories of diabetes, prior MI , cerebral infarction, multi-site MI, dyspnea, cardiogenic shock, heart failure, arrhythmia, ventricular fibrillation /ventricular tachycardia, pneumonia, high white blood cells account, low hemoglobin, the therapy without platelet aggregation inhibitor and statin drugs/ PCI were significantly associated with the in-hospital mortality within 30 days. Multivariate logistic regression analysis using mortality as the dependent variable and the history, in-hospital complication and so on as the independent variable showed that the major determinants of the in-hospital mortality were age, prior MI, cerebral infarction, multi-site MI, cardiogenic shock, heart failure, arrhythmia, pneumonia, high white blood cells account, the therapy without platelet aggregation inhibitor.3. Univariate analysis indicated that dyspnea, chest pain, inferior wall myocardial infarction, non-ST segment elevated myocardial infarction, histories of diabetes, prior M I, smoking, anaemia, hyperlipemia, cerebral infarction, cardiogenic shock, heart failure, arrhythmia, ventricular fibrillation, age, heart rate, plasma-albumin, hemoglobin, white blood cell count, LVEF value, creatine kinase, the therapy without platelet aggregation inhibitor, β receptor blocker, statin drugs, thrombolytics, anticoagulant, diuretic agent, digoxin, PCI were significantlyassociated with AMI complicated by pneumonia. Multivariate logistic regression analysis showed that the major determinants of the pneumonia were histories of diabetes, non-ST segment elevated myocardial infarction, heart failure, ventricularfibrillation, anaemia, age, heart rate, white blood cell count, PCI and temperature. Conclusions:1. Following aging, the elevating proportion of female, hypertension, histories of diabetes, prior MI, cerebral infarction, anaemia is significantly correlated with in-hospital mortality and complication within 30 days. Nevertheless, the proportion of hyperlipemia, smoking, drinking wine, platelet aggregation inhibitor, β receptor blocker, angiotension-converting enzyme inhibitor, thrombolysis and PCI degraded in aging patients.2. Those findings demonstrate that the age, prior MI, cerebral infarction, multi-site MI, cardiogenic shock, heart failure, arrhythmia, pneumonia, high white blood cells account, the therapy without platelet aggregation inhibitor are the independent impact factors of prognosis patients with cardiogenic death within 30 days.3.It is demonstrated that the histories of diabetes, non-ST segment elevated myocardial infarction, heart failure, ventricular fibrillation, anaemia, age, heart rate, white blood cells count, PCI and temperature are the independent impact factors of pneumonia in patients with AMI.