摘要
目的分析急性心肌梗死患者住院期间死亡的危险因素,为降低其死亡率提供依据。方法收集某院2012年1月1日-2019年10月31日14354例急性心肌梗死出院患者病案资料,以出院时是否死亡做为因变量,以性别、年龄、住院天数、就诊时间、医疗保险、吸烟史、陈旧性心肌梗死病史、病变血管数量、有无PCI治疗和各种合并症为影响因素,进行二分类logistic回归分析。结果年龄(OR:1.066,95%CI:1.055~1.077)、就诊时间(OR:1.155,95%CI:1.054~1.266)、糖尿病及其并发症(OR:1.712,95%CI:1.219~2.476)、液体-电解质紊乱(OR:1.240,95%CI:1.005~1.873)、心脏停搏(OR:6.184,95%CI:2.930~13.052)、心律失常(OR:2.354,95%CI:1.470~3.115)、脑梗死(OR:3.836,95%CI:2.165~4.936)、多根血管病变(OR:4.369,95%CI:3.105~6.149)和PCI治疗(OR:0.213,95%CI:0.118~0.384)对急性心肌梗死患者院内死亡的影响具有统计学意义(P<0.05)。结论对于年龄较大的老年AMI患者,入院后应早期或择期行PCI治疗,密切监护合并糖尿病并发症或循环系统疾病的患者,以降低急性心肌梗死住院患者的院内死亡率。
Objective To analyze the risk factors of death during hospitalization in patients with acute myocardial infarction(AMI).To provide the base for reducing the death rates.Methods The data of 14354 patients with acute myocardial infarction discharged from a hospital from January 2012 to October 2019 were collected.The death at discharge was taken as the dependent variable.The influencing factors were gender,age,length of stay,time of treatment,medical insurance,smoking history,history of old myocardial infarction,number of diseased vessels,PCI Treatment and various complications.Results Age(OR:1.066,95%CI:1.055~1.077),time of treatment(OR:1.155,95%CI:1.054~1.266),diabetes mellitus and its complications(OR:1.712,95%CI:1.219~2.476),fluid electrolyte disorder(OR:1.240,95%CI:1.005~1.873),cardiac arrest(OR:6.184,95%CI2.930~13.052),arrhythmia(OR:2.354,95%CI:1.470~3.115),cerebral infarction(OR:3.836,95%CI:2.165~4.936),multiple vascular diseases(OR:4.369,95%CI:3.105~6.149)and PCI treatment(OR:0.213,95%CI:0.118~0.384)had statistically significant effect on hospital death in patients with acute myocardial infarction(P<0.05).Conclusions For the elderly patients with AMI,PCI should be performed in the early or selective period after admission,and the patients with diabetic complications or circulatory system diseases should be closely monitored to reduce the in-hospital mortality of patients with AMI.
作者
齐向秀
Qi Xiangxiu(Shengjing Hospital Affiliated to China Medical University,Shenyang 110004,Liaoning Province,China)
出处
《中国病案》
2020年第5期109-112,共4页
Chinese Medical Record
基金
辽宁省科学技术厅重点研发计划指导项目(辽科发[2018]24号)。
