Hospital mortality of acute myocardial infarction in the thrombolytic era
Hospital mortality of acute myocardial infarction in the thrombolytic era
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DOI：
10.1136/hrt.81.5.478
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发表时间：
1999-05-01
期刊：
影响因子：
5.7
通讯作者：
Sugrue, DD
中科院分区：
文献类型：
--
作者：
Mahon, NG;O'Rorke, C;Sugrue, DD
Objective-To examine the management and outcome of an unselected consecutive series of patients admitted with acute myocardial infarction to a tertiary referral centre.Design-A historical cohort study over a three year period (1992-94) of consecutive unselected admissions with acute myocardial infarction identified using the HIPE (hospital inpatient enquiry) database and validated according to MONICA criteria for definite or probable acute myocardial infarction.Setting-University teaching hospital and cardiac tertiary referral centre.Results-1059 patients were included. Mean age was 67 years; 60% were male and 40% female. Rates of coronary care unit (CCU) admission, thrombolysis, and predischarge angiography were 70%, 28%, and 32%, respectively. Overall in-hospital mortality was 18%. Independent predictors of hospital mortality by multivariate analysis were age, left ventricular failure, ventricular arrhythmias, cardiogenic shock, management outside CCU, and reinfarction. Hospital mortality in a small cohort from a non-tertiary referral centre was 14%, a difference largely explained by the lower mean age of these patients (64 years). Five year survival in the cohort was 50%. Only age and left ventricular failure were independent predictors of mortality at follow up.Conclusions-In unselected consecutive patients the hospital mortality of acute myocardial infarction remains high (18%). Age and the occurrence of left ventricular failure are major determinants of short and long term mortality after acute myocardial infarction.
