2021年贝喀西县总医院ST段抬高型心肌梗死(STEMI)患者住院死亡率及危险因素分析

Khanza Rizqullah Syauqi, Mailani Karina Akhmad, Omar Mokhtar Siregar
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摘要

背景:急性冠脉综合征(ACS)是一种主要的心血管疾病,是世界上主要的死亡原因之一。st段抬高型心肌梗死(STEMI)是冠状动脉全闭塞的一个指标,需要使用纤溶药物或经皮冠状动脉介入治疗(PCI)重建血运以恢复血流和心肌再灌注。ACS患者早期治疗效果较好,住院死亡率降低。 目的:了解2021年Bekasi reggency General Hospital急性冠脉综合征(ACS)患者的患病率及st段抬高型心肌梗死(STEMI)患者院内死亡的危险因素。 研究地点和时间:2021年12月至2022年3月,贝卡西摄政总医院心内科和急诊室;方法:本研究是一项描述性横断面研究,使用二手数据(医疗记录),包括2021年1月至12月期间因胸痛或呼吸短促等主诉住院的所有35岁以上急诊室患者。本研究的最终样本为117名受试者。 结果:2021年ACS 117例。其中14%为STEMI, 15%为非st段抬高型心肌梗死(NSTEMI), 71%为不稳定型心绞痛(UAP)。大多数患者为男性(54%),65岁(85%)。住院死亡率为STEMI 19%, NSTEMI 17%, UAP 12%。16例STEMI患者中,81%为男性,94%为65岁。69%的人在12小时内来到急诊室,只有50%的人发生了纤维蛋白溶解。结论:STEMI患者院内死亡的危险因素为迟发性40%、前路STEMI 23%、高血压20%、糖尿病60%、慢性肾病50%、心动过速33%、Killip III型100%。
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Prevalence and Risk Factors of In-Hospital Mortality of ST Elevation Myocardial Infarction (STEMI) Patients in Bekasi Regency General Hospital in 2021
Background: Acute Coronary Syndrome (ACS) is a major cardiovascular problem and has been one of the leading death in the world. ST-Elevation Myocardial Infarction (STEMI) is an indicator of total coronary artery occlusion which requires revascularization to restore the blood flow and myocardial reperfusion using fibrinolytic agents or primary Percutaneous Coronary Intervention (PCI). Early treatment showed better outcomes and reduced in-hospital mortality in ACS patients. Aims: To determine the prevalence of Acute Coronary Syndrome (ACS) patients and the risk factors of in-hospital mortality of ST-Elevation Myocardial Infarction (STEMI) patients at Bekasi Regency General Hospital in 2021. Place and Duration of Study: Cardiology Department and Emergency Room Unit in Bekasi Regency General Hospital, December 2021 to March 2022 Methods: This study is a descriptive cross-sectional study using secondary data (medical records) which included all the patients over 35 years old that admitted through the ER from January to December 2021 with complaints including chest pain or shortness of breath which were later hospitalized. The final sample used in this study is 117 subjects. Results: There were 117 cases of ACS in 2021. They were 14% STEMI, 15% Non-ST Elevation Myocardial Infarction (NSTEMI), and 71% Unstable Angina Pectoris (UAP). Most patients were male (54%), and aged <65 years old (85%). The in-hospital mortality was 19% STEMI, 17% NSTEMI, and 12% UAP. Among 16 STEMI patients, 81% were male and 94% were aged <65 years old. There were 69% who came to the emergency room <12 hours and only 50% underwent fibrinolytic. Conclusion: The risk factors of in-hospital mortality of STEMI patients were 40% late onset, 23% anterior STEMI, 20% hypertension, 60% diabetes mellitus, 50% chronic kidney disease, 33% tachycardia, and 100% Killip III.
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