Myocardial infarction in persons aged ≥75 years: factors influencing inhospital mortality

I. E. Tishkina, T. M. Kuleshova, M. A. Frolova, K. Pereverzeva, S. Yakushin
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Abstract

Aim. To identify factors influencing inhospital mortality in patients with myocardial infarction aged ≥75.Material and methods. We performed a retrospective analysis of medical records of all patients aged ≥75 years hospitalized from January 1, 2020 to December 31, 2021 with a diagnosis of myocardial infarction (I21, ICD-10), assessment of comorbidities, clinical performance, laboratory and treatment data and their impact on the outcome of hospitalization.Results. Inhospital mortality was 22,2%. The mean age of discharged and deceased patients was 81 [79; 84] and 82 [79; 85] years, respectively (p=0,12). Cardiogenic shock on admission (hazard ratio (HR) 31,28; 95% confidence interval (CI) 5,7-171,53; p<0,001), degree 2-3 atrioventricular block (HR 4,67; 95% CI 1,02-21,38; p=0,04), as well as a GRACE score ≥166 for non-ST-segment elevation acute coronary syndrome (HR 7,19; 95% CI 1,01-51,43; p<0,001) showed an unfavorable effect on prognosis.Conclusion. Cardiogenic shock, degree 2-3 atrioventricular block, and a GRACE score ≥166 for patients with non-ST-segment elevation acute coronary syndrome are factors that increase inhospital mortality in patients aged ≥75 years.
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年龄≥75 岁的心肌梗死患者:影响住院死亡率的因素
目的确定影响年龄≥75岁心肌梗死患者院内死亡率的因素。我们对2020年1月1日至2021年12月31日期间所有年龄≥75岁、诊断为心肌梗死(I21,ICD-10)的住院患者的病历进行了回顾性分析,评估了合并症、临床表现、实验室和治疗数据及其对住院结果的影响。住院死亡率为 22.2%。出院和死亡患者的平均年龄分别为 81 [79; 84] 岁和 82 [79; 85] 岁(P=0,12)。入院时的心源性休克(危险比 (HR) 31,28; 95% 置信区间 (CI) 5,7-171,53; p<0,001)、2-3度房室传导阻滞(HR 4,67; 95% CI 1,02-21,38; p=0,04)以及非ST段抬高急性冠脉综合征的GRACE评分≥166(HR 7,19; 95% CI 1,01-51,43; p<0,001)对预后有不利影响。结论:心源性休克、2-3度房室传导阻滞以及非ST段抬高型急性冠状动脉综合征患者的GRACE评分≥166分是增加年龄≥75岁患者院内死亡率的因素。
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来源期刊
Russian Journal of Cardiology
Russian Journal of Cardiology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
2.20
自引率
0.00%
发文量
185
审稿时长
1 months
期刊介绍: Russian Journal of Cardiology has been issued since 1996. The language of this publication is Russian, with tables of contents and abstracts of all articles presented in English as well. Editor-in-Chief: Prof. Eugene V.Shlyakhto, President of the Russian Society of Cardiology. The aim of the journal is both scientific and practical, also with referring to organizing matters of the Society. The best of all cardiologic research in Russia is submitted to the Journal. Moreover, it contains useful tips and clinical examples for practicing cardiologists. Journal is peer-reviewed, with multi-stage editing. The editorial board is presented by the leading cardiologists from different cities of Russia.
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