中国急性心肌梗死患者住院期间死亡的危险因素分析 |
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引用本文: | 刘倩倩,伏蕊,宋晨曦,窦克非,杨进刚,高晓津,许海燕,王春玥,王杨,刘佳,刘慧,张鸿雁,杨圣印,杨跃进,无.中国急性心肌梗死患者住院期间死亡的危险因素分析[J].中国循环杂志,2020(1):24-30. |
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作者姓名: | 刘倩倩 伏蕊 宋晨曦 窦克非 杨进刚 高晓津 许海燕 王春玥 王杨 刘佳 刘慧 张鸿雁 杨圣印 杨跃进 无 |
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作者单位: | 中国医学科学院北京协和医学院国家心血管病中心阜外医院冠心病中心;中国医学科学院北京协和医学院国家心血管病中心阜外医院心血管疾病国家重点实验室;河南省濮阳市安阳地区医院心内科;山东省新泰市人民医院心内科;中国急性心肌梗死注册登记研究组 |
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基金项目: | 中国医学科学院医学与健康科技创新工程(2016-12M-1-009);CAMI-NSTEMI评分在中国非ST段抬高型心肌梗死患者死亡风险预测价值的研究(2018-F04) |
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摘 要: | 目的:探讨当代中国急性心肌梗死(AMI)患者住院期间死亡的危险因素。方法:纳入2013年01月至2014年09月中国急性心肌梗死(CAMI)注册登记研究的AMI患者23417例其中5795例非ST段抬高型心肌梗死(NSTEMI)患者和17622例ST段抬高型心肌梗死(STEMI)患者]。1504例患者在住院期间死亡,为死亡组,余住院期间生存的21913例患者为生存组。收集患者基线资料、实验室检查、治疗方法、院内结局等临床资料,以住院期间死亡为主要终点构建多因素Logistic回归模型,探讨AMI患者住院期间死亡的独立危险因素。结果:6.42%(1504/23417)的AMI患者在住院期间死亡。与生存组比较,死亡组患者年龄更大,女性患者更多,体重指数更低,合并糖尿病、高血压的比例更高,Killip心功能分级更高,并发症更多,并且更易出现心脏骤停(P均<0.05)。多因素Logistic回归分析结果提示,年龄、性别、体重指数、收缩压、心率、血肌酐水平、白细胞计数、血清钾浓度、血清钠浓度、STEMI、前壁心肌梗死、心脏骤停、Killip心功能分级、高血压、高脂血症及吸烟史是预测患者住院期间死亡的独立危险因素。结论:本研究发现16个当代中国AMI患者住院期间死亡的独立危险因素,有助于临床医师早期识别高危患者并选择最佳诊疗策略。
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关 键 词: | 心肌梗死 死亡率 危险因素 住院期间 |
Risk Factors Analysis for In-hospital Mortality in Patients With Acute Myocardial Infarction in China |
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Institution: | (Coronary Heart Disease Center,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing 100037,China;不详;Group of China Acute Myocardial Infarction Registry) |
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Abstract: | Objectives:To explore the risk factors for in-hospital mortality among contemporary patients with acute myocardial infarction(AMI)in China.Methods:The information of 23417 AMI patients(including 5795 NSTEMI and 17622 STEMI)from 2013-01 to 2014-09,derived from China Acute Myocardial Infarction(CAMI)registry,was extracted.Our research included 2 groups:In-hospital death group(n=1504)and In-hospital survival group(n=21913).The baseline condition,laboratory examination,treatment and the inhospital outcomes were compared;the independent risk factors for in-hospital mortality were evaluated by multivariable logistic regression analysis.Results:6.42%(1504/23417)patients died during hospitalization.The baseline conditions were different between 2 groups.Multivariable logistic regression analysis indicated that age,gender,body mass index,systolic blood pressure,heart rate,creatinine level,white blood cell count,serum potassium,serum sodium,ST-segment elevation on ECG,anterior wall involvement,cardiac arrest,Killip classification,medical history of hypertension,medical history of hyperlipidemia and smoking status were the independent risk factors for in-hospital mortality in AMI patients.Conclusions:The above mentioned 16 variables are the independent risk factors for in-hospital mortality among contemporary AMI patients.Special care should be applied to AMI patients with above risk factors and these patients at risk should be treated accordingly to reduce the incidence of in-hospital death in daily clinical practice. |
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Keywords: | myocardial infarction mortality risk factors in-hospital |
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