Prognostic Efficacy of Early Clinical Categorization of Myocardial Infarction Patients
Prognostic Efficacy of Early Clinical Categorization of Myocardial Infarction Patients
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心肌梗死患者早期临床分类的预后效果
DOI：
10.1161/01.cir.56.5.816
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发表时间：
1977
期刊：
影响因子：
37.8
通讯作者：
G. Voigt
中科院分区：
文献类型：
--
作者：
M. Pozen;J. Stechmiller;G. Voigt
为了评估24-36小时“低风险”分类作为早期转移到中间冠心病监护病房的基础的预后有效性，将Killip和Hutter/Sidel风险分类标准应用于410例急性心肌梗死（MI）患者，并前瞻性比较死亡率和发病率。根据Killip分类，6%的“低风险”患者随后死亡，因此被错误分类。根据Hutter/Sidel标准分类为“低风险”的患者中没有患者死亡;然而，从该组中排除的潜在“低风险”患者超过2.5倍。关于发病率，35/87例（40%）被Hutter/Sidel标准归类为“低风险”的患者在住院期间发生了43例严重并发症。其中9名患者在第6天或之后发生了43例并发症中的11例（26%），其中5名患者在住院期间发生了首次重大并发症。尽管“低危”患者作为一个群体的死亡率较低，但在发展中级冠状动脉监护病房时必须考虑到这种显著的发病率。
To assess the prognostic validity of "low risk" classification at 24-36 hours as the basis for early transfer to an intermediate coronary care unit, Killip and Hutter/Sidel criteria for risk classification were applied to 410 patients with acute myocardial infarction (MI) and prospectively compared with respect to mortality and morbidity. Six percent of "low risk" patients by the Killip classification subsequently died and were therefore misclassified. No patients in the group classified as "low risk" by the Hutter/Sidel criteria died; however, more than two and a half times as many potentially "low risk" patients were excluded from this group. With respect to morbidity, 35 of 87 patients (40%) classified as "low risk" by Hutter/Sidel criteria developed 43 major complications during their hospitalization. Nine of these patients developed 11 of the 43 complications (26%) on day six or later, and for five of these patients, this was their first major complication during hospitalization. This significant incidence of morbidity in "low risk" patients, despite their low mortality rates as a group, must be taken into account in developing intermediate coronary care units.