The Predictors Of In-hospital Mortality In High Risk Acute Coronary Syndrome Patients After Percutaneous Coronary Intervention Assisted By Intra-aortic Balloon Pump

Objective In order to evaluate the predictive value of the clinical parameters that can be obtained at the initial admission stage in hospital for the patients in high risk with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI),we want to investigate the predictors of in-hospital mortality patients in high risk with ACS after PCI assisted by intra-aortic balloon pump(IABP).We hope that this study can provide a reference for rapidly confirming the prognosis of these patients and making t he appropriate treatment plans,and reduce the mortality of these patients during hospitalization.Methods In this study,we selected 86 patients in high risk with ACS after PCI assisted by IABP who were hospitalized in our hospital from January 2011 to October 2016.According to the patient's death during hospitalization,we divided them into survival group and death group,among which 69 cases of survival group and 17 cases of death group.We collected the clinical data of these patients and made a univariate analysis for clinical data between the two groups to obtain the potential risk factors with significant correlation with the death during hospitalization(P < 0.05).Finally,we analyzed the potential risk factors associated with the death during hospitalization by the forward Binary Logistic regression Analysis and determine the independent risk factors associated with the mortality of the patients with ACS in high risk after PCI assisted by IABP.Results The results of the general clinical characteristics of these patients: The average age was 69.67± 11.31.The maximum age is 90.The minimum age is 42 years.60(69.80%)cases were men.26(30.20%)cases were women.The ratio of men to women was 2.31:1.65(75.60%)cases were admitted to STEMI.16(18.60%)cases were accompanied by nausea and vomiting.14 cases(16.3%)were associated with loss of consciousness.27 cases(31.4%)combined with cardiogenic shock.13 cases(15.10%)combined malignant arrhythmia.33 cases(38.4%)used IABP before PCI.The cardiac-function of 53 cases(61.63%)were higher than grade III.17 cases(19.80%)died.Results of clinical data single factor analysis of death group and survival group.The patients in the death group were older than the survival group(76.47±9.08 year vs.68.00±11.23 year),had more woman(64.7%vs.21.7%),had more patients with loss of consciousness(41.2%vs.10.1%),had more patients whose cardiac function was higher than grade III(82.4%vs.56.5%),had more patients combined with cardiogenic shock(70.6%vs.21.7%)and had more patients happened slow blood flow after PCI(17.6%vs.0.0%).The average serum glucose(14.96±7.90mmol/L vs.7.71±3.37 mmol/L),serum creatinine(168.12±96.20 umol/L vs.83.70±33.80 umol/L)and uric acid(465.78±208.24 umol/L vs.357.93±94.99 umol/L)level were higher in the death group.Carbon dioxide(19.48±5.09 mmol/L vs.22.45±3.33 mmol/L)and LVEF(41.24±8.01 vs.52.78±8.56)were lower in the death group.The difference was statistically significant(P<0.05).The binary Logistic regression analysis results show that age(OR=1.221),LVEF(OR=0.746),cardiac function(OR=0.210),blood sugar(OR=1.381)and creatinine(OR=1.034)were the independent risk factors for predicting in-hospital mortality in high-risk ACS patients received PCI therapy assisted by IABP.Conclusions the independent risk factors for predicting in-hospital mortality in high-risk ACS patients received PCI therapy assisted by IABP were age,LVEF,cardiac function,blood glucose,creatinine.Significance Patients with ACS in high risk are older,the body has poor basic function,the underlying disease is more complicated and the vascular disease is more complicated and diverse,the medical history is longer.Their state of the illness were more dangerous and doctors need to quickly develop a treatment plan.Now,Through our research to investigate the predictors of in-hospital mortality patients in high risk with ACS after PCI assisted by IABP,we could provide a reference for the prognosis of these patients,also could to provide some clinical thinking for the establishment of early treatment strategies.