Improved prognosis since 1969 of myocardial infarction treated in a coronary care unit: lack of relation with changes in severity.
Improved prognosis since 1969 of myocardial infarction treated in a coronary care unit: lack of relation with changes in severity.
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自 1969 年以来，在冠心病监护室接受治疗的心肌梗塞的预后得到改善：与严重程度的变化缺乏关系。
DOI：
10.1136/bmj.299.6704.892
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发表时间：
1989
影响因子：
--
通讯作者：
W. Chan
中科院分区：
文献类型：
--
作者：
J. Hopper;B. Pathik;D. Hunt;W. Chan
目的：研究1969年至1983年在冠心病监护室接受治疗的急性心肌梗死患者预后的变化。设计--对所有确诊急性心肌梗死患者的死亡率进行随访。环境--皇家墨尔本医院的冠心病监护室，一个三级转诊中心。对象：1969年至1983年收治的4253例患者（3366例男性，887例女性）。主要观察指标--出院时和入院后12个月记录的死亡率。结果：入院时详细记录临床表现、病史、心电图、心律失常和放射学表现。女性的平均年龄为63岁，男性为57岁，女性的血液动力学梗死比男性更严重。在后来的几年里，患者年龄较大，梗死不太严重。总体而言，1969-73年男性的住院死亡率为16.7%，1979-83年为8.5%，诺里斯和基利普梗死严重程度指数的所有等级均下降，而女性的住院死亡率则保持不变，为19.2%。即使通过logistic回归调整了年龄和严重程度，男性的住院死亡率平均每年下降8%（95%置信区间为4%至11%），但女性的住院死亡率保持不变。到1983年，男性的死亡率是60%的妇女的年龄和可比的严重性梗死。即使在调整了年龄和严重程度后，12个月时医院幸存者的死亡率在男女中每年下降7%（4%至9%），男性与女性的死亡率比约为0.8。新的指数被用来预测住院和12个月时的死亡率。结论：观察到的死亡率下降不能用梗死严重程度或患者预后特征的变化来解释。
OBJECTIVE--To study changes from 1969 to 1983 in the prognosis of patients with acute myocardial infarction treated in a coronary care unit. DESIGN--Mortality follow up of all patients with definite acute myocardial infarction. SETTING--The coronary care unit of the Royal Melbourne Hospital, a tertiary referral centre. SUBJECTS--4253 Patients (3366 men, 887 women) admitted from 1969 to 1983. MAIN OUTCOME MEASURE--Mortality recorded at discharge from hospital and 12 months after admission. RESULTS--Details of clinical findings, history, electrocardiograms, arrhythmias, and radiological findings were recorded on admission. Mean ages were 63 for women and 57 for men, and women had haemodynamically more severe infarcts than men. In the later years patients were older and had less severe infarcts. Overall, hospital mortality in men was 16.7% in 1969-73 and 8.5% in 1979-83 and declined in all grades of the Norris and Killip infarct severity indices compared with a constant 19.2% in women. Even after adjustment for age and severity by logistic regression, hospital mortality fell in men by an average of 8% (95% confidence interval 4% to 11%) a year but remained constant in women. By 1983 male mortality was 60% that of women of similar age and comparable severity of infarction. Mortality of hospital survivors at 12 months declined by 7% (4% to 9%) a year in both sexes, even after adjustment for age and severity, with a male to female mortality ratio of about 0.8. New indices were derived to predict mortality in hospital and at 12 months. CONCLUSION--The observed declines in mortality cannot be explained by changes in severity of infarction or in prognostic characteristics of patients.
急性心肌梗死时的吸烟状况及其预后。
影响因子：
4.8
作者：
Kelly,TL;Gilpin,E;Ahnve,S;Henning,H;RossJr,J
通讯作者：
RossJr,J
DOI：
10.1016/0002-9343(84)90857-x
发表时间：
1984
期刊：
The American journal of medicine
影响因子：
--
作者：
Gillum,RF;Folsom,AR;Blackburn,H
通讯作者：
Blackburn,H