Analysis Of In-hospital Mortality And Associated Factors In Patients With Acute ST Segment Elevation Myocardial Infarction

Objective:To investigate the general characteristics,previous history,auxiliary examination,treatment and complications of hospitalized patients with STEMI and analyse hospital mortality and related factors of patients with STEMI for providing the guidance of clinical treatment.Methods:A total of 2766 hospitalized patients diagnosed as STEMI were collected from Department of Cardiology of Bethune First Hospital of Jilin University from2014.06.01 to 2015.12.31 including 132 died and 2634 survived.Firstly,the relationship between hospital mortality and sex,age,reperfusion therapy and myocardial infarction area of overall patients with STEMI was analyzed.Secondly,109 patients with complete history date in the dead patients were selected as the death group,and 436 patients of the survival patients were randomly chosen from survival patients who meeting the conditions matched by age(±10 years),sex,hospitalization time(±3 months)and myocardial infarction area as the control group.And then,the differences of two groups of patients in the general condition,previous history,auxiliary examination,treatment and complications were analyzed and compared.Results:1.In this study,the overall hospital mortality rate of patients with STEMI was 4.8%(132/2766).Hospital mortality of patients with STEMI was various under different factors.In terms of age,hospital mortality of the elderly group was higher than the youth group and middle age group.In terms of treatment,hospital mortality of the conservative group was higher than the emergency PCI group and the elective PCI group In the area of myocardial infarction,hospital mortality of the extensive anterior myocardial infarction was higher than other parts of the myocardial infarction group,and hospital mortality of the inferior?right ventricular?posterior wall and anteroseptal myocardial infarction lower than other parts of the myocardial infarction group.2.The differences of patients of death and survival groups compared by univariate analysis among Heart rate,systolic blood pressure,diastolic blood pressure,Killip grade,heart function EF value,CKMB value,admission random blood glucose,serum creatinine,leukocyte,absolute value of neutrophil and eosinophil,distribution width of red blood cell,heart failure,cardiogenic shock,mechanical complications,arrhythmia,ventricular tachycardia,ventricular fibrillation,three-degree atrioventricular block,completed right bundle branch block,bigeminal antiplatelet drugs,beta blockers,ACEI/ARB,statin drugs and diuretics were statistically significant(P <0.05).3.Multifactorial COX regression analysis: Killip grade,ventricular fibrillation,complete right bundle branch block and mechanical complications is the independent risk factor for STEMI patients died during hospitalization.Conclusion:1.The use of emergency PCI and delayed PCI can significantly reduce hospital mortality of STEMI patients.2.The risk of in-hospital death in patients with acute extensive anterior myocardial infarction is higher than that in the rest of the myocardial infarction group.3.Hospitalized Killip grade,ventricular fibrillation,complete right bundle branch block and mechanical complications is the independent risk factor for STEMI patients died during hospitalization.