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Background: To compare TIMI & HEART SCORE for their risk stratification in Acute Myocardial Infarction Patients, prognostic accuracy and Arrhythmia incidence.Methods: This observational study is conducted in a Tertiary care hospital over a period of 2 years from August 2017 to July 2019. A total of 100 patients presented to ER with Chest Pain are selected for study. Patients were monitored for a period of one month in ICCU.Results: In present study out of 61 cases with TIMI score ≥5, mortality of 11.5%(7 cases, p value 0.028). Heart score more than 6 constitutes high risk group, out of which mortality was observed in 7.45% cases (p=0.48). Most of the arrhythmias (70.49%) in present study observed in patients with TIMI score ≥5 (High risk group) which is statistically significant with p value 0.002. Most of the arrhythmias in present study observed in patients with HS ≥8 which is not statistically significant with p value 0.135.Conclusions: In present study, overall mortality rate was 7% and these patients who died constitutes to high risk group with TIMI. HEART SCORE identified more patients as low risk compared to TIMI SCORE. TIMI SCORE is a good predictor of arrhythmia incidence.
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Objective To comprehensively analyze the nursing measures of early thrombolytic therapy for acute myocardial infarction. Methods 140 patients with acute myocardial infarction admitted in our hospital from October 2013 to October 2016 were randomly divided into control group (70 cases) and experimental group (apply early thrombolytic care on the basis of routine nursing method, 70 cases) according to different nursing methods. SPSS20.0 statistical software was used to analyze the incidence of complications, mean hospitalization time, average bedridden time and total satisfaction. Results The average hospital stay and the average length of stay in the experimental group were much shorter than those in the control group (P<0.05). The total score of the experimental group was much higher than that of the control group (P<0.05). The complication rate of the experimental group was much lower than that of the control group (P<0.05). Conclusion Nursing measures for early thrombolytic therapy in patients with acute myocardial infarction can significantly reduce the incidence of complications in patients.
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Objective To comprehensively analyze the nursing measures of early thrombolytic therapy for acute myocardial infarction. Methods 140 patients with acute myocardial infarction admitted in our hospital from October 2013 to October 2016 were randomly divided into control group (70 cases) and experimental group (apply early thrombolytic care on the basis of routine nursing method, 70 cases) according to different nursing methods. SPSS20.0 statistical software was used to analyze the incidence of complications, mean hospitalization time, average bedridden time and total satisfaction. Results The average hospital stay and the average length of stay in the experimental group were much shorter than those in the control group (P<0.05). The total score of the experimental group was much higher than that of the control group (P<0.05). The complication rate of the experimental group was much lower than that of the control group (P<0.05). Conclusion Nursing measures for early thrombolytic therapy in patients with acute myocardial infarction can significantly reduce the incidence of complications in patients.
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Objective To study the protective role of continuous veno-venous hemofiltration (CVVH) in cardiac insufficiency refractory to diuretic therapy after acute myocardial infarction.Methods A total of 104 acute myocardial infarction patients admitted from march 2012 to march 2016 were recruited.According to their wishes,the patients were divided into two groups,continuous veno-venous hemofiltration combined with routine therapy as experimental group (n =52) and conventional treatment as control group (n =52).Mortality rate within one month,the mean length of ICU stay,the mean length of hospital stay,ventilator usage and urine output volume were documented.Then the difference in BW between pre-and post-treatment was determined for evaluation of fluid retention,and blood plasma C-reactive protein (ΔCRP),interleukin 6 (ΔIL-6),interleukin 8 (ΔIL-8),tumor necrosis factor-α (ΔTNF-α) and left ventricular ejection fraction (ΔLVEF) were measured and calculated.A multiple linear regression model to predict ΔLVEF was established.Data recorded at different intervals in the same group were analyzed by ANOVA.Data of the monitoring biomarkers,the mean length of ICU stay,the mean length of hospital stay of two groups were recorded at the same given intervals were analyzed by t test.Data of mortality rate within one month,drugs and ventilator usage in two groups were analyzed by x2 test.P value less than 0.05 was considered statistically significant.Results There were significant differences in mortality rate within one month,the mean length of ICU stay,the mean length of hospital stay,and the duration of ventilator usage between the two groups (P ＜ 0.05).Total volume of fluid output (urine and ultrafiltration volume) was higher in experiment group than that in control group in 48 hours after the treatment (P ＜ 0.01).The levels of CRP,IL-6,IL-8 and TNF-α decreased significantly (P ＜ 0.05) in experiment group after treatment but not in control group (P ＞ 0.05) as compared with those before the treatment.BW was decreased and LVEF was increased in both groups after treatment (P ＜ 0.05) compared with those before the treatment.Levels of CRP,IL-6,IL-8 and TNF-α were lower in experiment group than those in control group after treatment (P ＜ 0.05).BW was meagerly lower and LVEF was meagerly higher in experiment group than those in control group without statistical significance (P ＞ 0.05).However,the degrees of ΔLVEF andΔBW were greater in experiment group than those in control group (P ＜ 0.01).In experiment group,significantly positive correlations were found among ΔBW,ΔCRP,ΔIL-6,ΔIL-8,ΔTNF-α and ΔLVEF (P ＜0.05).Multiple linear regression analyses showed that ΔBW and ΔTNF-α were the independent factors forΔLVEF and ΔBW was the main independent factor for ΔLVEF in control group.ΔLVEF was positively correlated with ΔBW (P＜0.01) but had no correlation with ΔCRP,ΔIL-6,ΔIL-8 and ΔTNF-α (P ＞0.05).Multiple 1inear regression analyses showed that only ΔBW was the independent factor for ΔLVEF.Conclusion CVVH plays protective role in acute myocardial infarction patients with consequent cardiac insufficiency refractory to diuretic therapy by clearance of inflammatory cytokines and removal of retained fluid,and the removal of retained fluid is the most import mechanism to protect heart function.