E0603 The inhospital mortality and its determinants for elderly patients with acute myocardial infarction. (17th November 2010) - Zhao, Whenshu
Abstract : Objective: To explore the inhospital mortality and its determinants for elderly patients with acute myocardial infarction. Method: Totally four hundreds and ninety nine patients with acute myocardial infarction, hospitalised in our hospital from January 1, 2002 through February 22, 2010, who were equal or above 80 years older, were retrospectively analysed. Results: Among these 499 cases, 97 patients died during hospitalisation, with total inhospital mortality being 19.4%. Of these patients, there were 297 cases with acute ST segment elevated myocardial infarction (STEAMI) and 202 cases with non -ST segment elevated myocardial infarction (NSTEAMI), and their inhospital mortality were 23.2% and 13.9%, respectively (p=0.009). Univariable analysis showed the proportions of infection, digest tract bleeding, history of hypertension, complete atrial-ventricular (A-V) block, cardiac rupture, three or four killip grade of cardiac function, and STEAMI in death group were higher than that in alive group (p<0.05), and the mortality of those who did not undergo urgent PCI was higher (p<0.05). Multivariable logistic regression analysis showed the independent determinants for mortality of elderly AMI patients were cardiac killip grades, complete A-V block, renal dysfunction, stent implant, and the type of AMI. Conclusions: The independent determinants for mortality of elderly AMI patients are as following, cardiac killip grade, complete A-V block, renal dysfunction, stent implant, and the type of MAI. Urgent PCI is safe and effective for elderly with AMI.