Analysis Of Influence Factors Of Hospitalization Outcomes In 303 Patients With IABP Implanted

Objective To analyze the influencing factors of inpatient outcomes of patients with intra-aortic balloon counterpulsation pump(IABP)implantation in general hospital of Ningxia Medical University.Methods A retrospective analysis was performed on 303 patients receiving IABP adjuvant and supportive treatment in Ningxia Medical University hospital from July 2008 to August 2018.According to the in-patient outcomes,the patients were divided into the survival group(n=202 cases)and the death group(n=101 cases),and the clinical characteristics and influencing factors of in-patient outcomes of the two groups were compared.Results The average age of the 303 patients(63.6±12.5)year,was 78.9%(n=239)male,21.1%(n=64)female,and 3.74:1 male.In recent 10 years,the in-hospital mortality rate of IABP users in our hospital showed a gradually decreasing trend,with the total in-hospital mortality rate of 33.3%.Patients with IABP were mainly diagnosed with acute myocardial infarction(78.55%),and patients with CS accounted for 45.56%.The timing of insertion was preoperative(48.18%).Baseline data of patients in the two groups were compared.Patients in the survival group had hypertension,type 2 diabetes,smoking history,drinking history,pulmonary infection,previous chronic renal insufficiency,atrial fibrillation,ventilator use,vasoactive drug use,and vascular injury complications were lower than those in the death group(P<0.05).The increase of systolic blood pressure,diastolic blood pressure and ejection fraction(EF%)in the survival group was greater than that in the death group,and the increaseof left ventricle distal diameter was lower than that in the death group before and after IABP implantation,and the difference was statistically significant(P<0.05).The comparison of laboratory indicators between the two groups showed that the differences of leukocyte,hemoglobin,platelet,creatinine,urea nitrogen,albumin,D-D polymer,BNP,cTnI,arterial blood lactic acid and arterial oxygen saturation were statistically significant(P < 0.05).At the same time,we observed that the mean blood glucose level in the death group [(17.61.88)mmol/Lvs.(9.25 1.05)mmol/L,P=0.033] was higher than that in the survival group.Through Logistic regression analysis,we found that age(? 65 years old),male,preoperative LVEF value,Killip grade(?III level),post-intervention TIMI blood flow grade(?2 level),duration of IABP use(?90h),femoral artery injury,hospitalized creatinine,lactic acid,and blood glucose levels were independent risk factors affecting the in-hospital death of patients with IABP implantation.The independent risk factors of patients with IABP implantation were analyzed by the quarterwise analysis method.The risk of death increased by 8.3% for every 4.15(mmol/L)increase in blood glucose level.For every 5.05 mmol/L increase in arterial lactic acid,the risk of death increased by 23.5%.Preoperative LVEF(%)decreased by 21.2% for each 8% increase.Conclusion 1.Acute myocardial infarction combined with cardiogenic shock is the main reason for the implantation of IABP in our hospital,and the patient's own factors are important factors affecting the outcome of hospitalization;2.Improving TIMI blood flow after intervention is an important determinant of survival of patients with IABP implantation.