Predictive factors of in-hospital mortality in ST-segment elevation acute myocardial infarction

Abstract

Introduction: Many factors have been associated with high in-hospital mortality in acute myocardial infarction (AMI). Objectives: To determine the risk factors of in-hospital death in patients with ST-segment elevation acute myocardial infarction. Method: A case-control analytical study was carried out with the 94 patients who died due to myocardial infarction (study group) between January 2011 and December 2016. For each of them, two surviving patients were randomly chosen (control group). Descriptive statistics through percentage analysis and arithmetic mean were applied. A multiple logistic regression model was used to determine the risk factors of in-hospital mortality. Results: The deceased had an average age of 73±11 years, 81.9% were hypertensive, 78.8% did not receive thrombolysis or was ineffective, 72.3% arrived late and had greater complications than those of the control group. Cardiogenic shock (OR 22.59), blood glucose greater than 15 mmol/L (OR 6.60) and between 7.3-15 mmol/L (OR 2.22), biventricular AMI (OR 4.27), late arrival to first medical assistance facility (OR 3.83), age over 70 years (OR 3.62), and creatinine greater than 200 μmol/L (OR 2.93) were statistically significant for in-hospital mortality. Conclusions: Cardiogenic shock, blood glucose greater than 15 mmol/L and between 7.3-15 mmol/L, biventricular AMI, late arrival to first medical assistance facility, age over 70 years, and creatinine >200 μmol/L behaved as risk factors for in-hospital mortality.