Analysis Of Risk Factors For In-hospital Death In Patients With Acute ST-segment Elevation Myocardial Infarction

Objective : To investigate the risk factors of in-hospital death in patients with acute ST-segment elevation myocardial infarctionMethods :Continuously selected patients from the General Hospital of Ningxia Medical University from January 1,2015 to December 31,2017 to diagnose acute ST-segment elevation myocardial infarction.2386 patients met the inclusion criteria,of which 105 patients were hospitalized.After death,2281 patients were discharged from the hospital.At the same time,420 patients were randomly matched with age(±10 years),gender,and hospitalization time(±3 months)according to the 1:4 protocol.Record general information of selected cases,such as gender,age,presence or absence of hypertension,diabetes,cerebrovascular disease,history of smoking,history of drinking,etc.,admission blood pressure,heart rate,cardiac function classification(Killip classification),myocardial infarction;The first blood routine,biochemical complete set,myocardial injury markers,coagulation,and hypersensitive CRP were recorded.The first echocardiogram was admitted to the hospital.The EF value,presence or absence of ventricular aneurysm,presence or absence of myocardial wall abnormalities,and post-hospital complications and complications were recorded.Analyze factors that influence the patient’s in-hospital death.Results:1.Among the 2386 STEMI patients,1863 were males,523 were females,105 were overall deaths,and the in-hospital mortality rate was 4.4%(105/2386);64 male deaths,3.56% mortality,41 female deaths,and deaths The rate was 8.51%;there was a statisticaldifference between male and female(P<0.05).2.(1)There was no significant difference in previous hypertension and cerebrovascular disease between the two groups(P>0.05).(2)There was a statistically significant difference in the history of previous diabetes between the two groups(P<0.05).(3)The blood pressure of the death group was lower than that of the survival group,the heart rate was faster than that of the survival group,the heart function was worse than that of the survival group,and there was already shock at the time of admission.The above indicators were statistically different(P<0.05).(4)the death group had white blood cell counts,Neutrophil/lymphocyte ratio,CRP,blood glucose,urea nitrogen,creatinine,PT,FIB,D-dimer were higher than the survival group(P<0.05);(5)The distribution of albumin,hemoglobin and red blood cells in the death group was lower than that in the survival group(P<0.05).There was no significant difference in myocardial injury marker troponin I between the two groups(P>0.05).(6)Patients with extensive anterior wall infarction were more likely to have in-hospital death(P<0.05);(7)In terms of arrhythmia and complications: atrial fibrillation,complete right bundle branch block,third degree atrioventricular block,ventricular tachycardia/ventricular fibrillation,and mechanical complications increased the risk of in-hospital death(P<0.05).3.Binary logistic regression analysis showed: shock,ventricular arrhythmia,extensive anterior wall infarction,elevated hypersensitivity CRP,increased white blood cell count,and risk factors for hospital mortality in STEMI patients at admission.Conclusion:1.The in-hospital mortality rate of patients with acute ST-segment elevation myocardial infarction was 4.4%;the female mortality rate was higher than that of males.2.Shock,rapid ventricular arrhythmia(ventricular tachycardia /ventricular fibrillation),extensive anterior wall infarction,increased white blood cell count,elevated CRP is a risk factor for hospital mortality in STEMI patients.