Prediction of acute myocardial infarction outcome: A record based cohort study
Dr. Vinod RK, Dr. Prashanth L, Dr. Suresh KP
Context: In this research work, death as an outcome was predicted among Acute Myocardial Infarction patients. The said outcome was analyzed with patient related demographic and risk variables, for determining factors influencing the poor prognosis. Objectives 1. To predict the outcome of Acute Myocardial Infarction (AMI) patients, 2. To predict death as an outcome after AMI, using demographic and risk variables. Methods: Record based retrospective cohort study was conducted at a hospital in Gulbarga city, India. Data for 6 months (May-Nov 2006) was collected from case-sheets of 112 patients diagnosed with AMI. Statistical analysis: Chi-square and other appropriate tests. Results: Patient associated demographic (6) and risk (6) variables were analyzed with outcome of AMI episode (Survived or Died). Out of the 112 patients studied, 71 had survived (63.4%) and 41 (36.6%) had died. Among the demographic variables, death as outcome was most prevalent among elderly (>70 yrs) age group (48.3%), females (41.7%), urban residents (37.5%), patients with symptom onset between 12 am – 8 am (38.2%), patients with upto 6 hrs of time elapsed before initiation of treatment (37.5%), and patients with hospital stay of <48 hrs (79.3%). Hospital stay (<48 hrs) was found to be significantly associated with death as outcome. Among the risk variables, death as outcome was most prevalent among patients with past history of cardiovascular diseases (35.3%), diabetes (29.1%), hypertension (40%), non-smokers (36.8%) and alcoholics (30.8%) and in those with normal lipid profiles (32.9%). Conclusion: Although data shows association between some of these variables with death as outcome among AMI patients, only duration of hospital stay was significantly associated. Risk factors thus determined, will enable implementation of effective interventions to prevent death among AMI patients.