Preditores de mortalidade hospitalar na era trombolítica para o infarto agudo do miocárdio em Salvador (BA) / Predictors of Hospital Mortality in the Thrombolytic Era for Acute Myocardial Infarction in Salvador (BA) - Brazil
Arq. bras. cardiol
;
68(4): 249-255, Abr. 1997.
Artigo
em Português
| LILACS
| ID: lil-320342
RESUMO
PURPOSE:
To determine the cumulative incidence and risk factors of in-hospital death due to acute myocardial infarction (AMI) in the thrombolytic era and to assess the degree of incorporation of new therapeutical interventions to the treatment of AMI in Salvador, Brazil.METHODS:
A retrospective study based on medical records of 388 patients hospitalized with an AMI in different hospitals between January 1993 and December 1994. The relative risk (RR) was used as a measure of association for the unadjusted analysis. To control for possible confoundears and to assess interactions, odds ratios (OR) were used to estimate the RR, by logistic regression models.RESULTS:
During the hospitalization period 50 (12.9) patients died. The main predictors of hospital mortality in the unadjusted comparisons were older age (age > 60 years) (RR = 2.76; p < 0.01), female gender (RR = 2.08; p = 0.01), Killip class > 1 (RR = 5.73; p < 0.01), anterior wall AMI (RR = 1.92; p = 0.02), previous stroke (RR = 4.13; p < 0.01) and systemic disease (RR = 2.76; p < 0.01). In the multivariate analysis, older age (OR = 2.42; p = 0.02), Killip class > 1 (OR = 7.14; p < 0.01), anterior wall AMI (RR = 2.37; p = 0.02) and previous stroke (RR = 2.34; p = 0.04) were the main independent predictors of hospital death. Thrombolytic therapy was used in 143 patients (36.8), aspirin in 322 (83), beta blockers in 204 (52.6) and heparin in 248 (63.9). Cardiogenic shock was responsible for more than half of the death cases.CONCLUSION:
Based on the data presented, older age, Killip class and anterior wall infarction are still important predictors of death due to AMI in the thrombolytic era, confirming other studies.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Terapia Trombolítica
/
Mortalidade Hospitalar
/
Infarto do Miocárdio
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Português
Revista:
Arq. bras. cardiol
Assunto da revista:
Cardiologia
Ano de publicação:
1997
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Universidade Federal da Bahia (UFBA)/BR
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