PREDICTORS OF IN HOSPITAL MORTALITY OF ACUTE MYOCARDIAL INFARCTION

Eliverta Zera ?, Ira Xhemollari, Sonila Xinxo

ABSTRACT

Background: Acute Myocardial infarction (AMI) is the main cause of death in the world. Survival is markedly influenced by age of the patient, sex, presence of different risk factors and complications that patients develop after myocardial infarction. Aim.To investigate the predictors of in hospital fatal outcome among patient with AMI. Methods: Four hundreds and ninety-nine patients with AMI, hospitalized in Cardiology Department of Durres Hospital, Albania during October 2011 to October 2014, were divided in two groups: survived and deceased (patients deceased during hospitalization due to AMI). The impact of the risk factors (age, gender, smoking, hypertension, diabetes mellitus, multi vessels disease, Killip class, level of creatinemia) in hospital mortality was evaluated by using logistic regression analysis and correlation technique. A p value <0.05 was considered statistically significant. Results: Out of 499 patients, 346 (69.3%) were males and 64 (30.7%) were females. The mean age was 65.5 ±11.4 years. Fifty one (10.3%) patients died during hospitalization due to AMI. The age group > 70 years old increased the likelihood of dying in hospital with 2-3 times (OD=2.2, OD=3.1 p <0.05) compared to other groups of age (respectively 60-70 years old and less than 60 years old). Being female and use of smoking is associated with a higher risk of 2.5 (OD=2.5 p<0.05) of in hospital mortality. Killip Class >II increased 11 times the likelihood of in hospital mortality (OD=1, p<0.05). In addition, a multi-vessel disease is associated with an increased about 8 times the likelihood of in hospital mortality (OD=7.8, p<0.05). Meanwhile, the presence of diabetes or high blood pressure did not impact on hospital mortality rate among in patients with an AMI. The coefficient of correlation for relationship between level of creatinemia and occurrence of fatal income is 0.293 (p<0.05). Conclusions: Age, gender, Killip class >II, multi-vessel disease and smoking should be considered as predictors of in-hospital mortality after an episode of AMI. In addition, a high level of creatinemia is predictor of in-hospital mortality.

Keywords: acute myocardial infarction, in-hospital mortality, predictor.