Summary

Short-term prognostic factors in elderly patients treated in emergency departments for acute coronary syndrome with ST segment elevation

Montiel Dacosta JA, Santaló I Bel M, Balaguer Martínez JV, Temboury Ruiz F, Povar Marco J, Gich Saladich I

Affiliation of the authors

Servicio de Urgencias. Hospital de la Santa Cruz y San Pablo. Barcelona, Spain. Servicio de Urgencias. Hospital Clínico de Valencia. Spain. Servicio de Urgencias. Hospital Clínico Universitario Virgen de la Victoria. Málaga, Spain. Servicio de Urgencias.

DOI

Quote

Montiel Dacosta JA, Santaló I Bel M, Balaguer Martínez JV, Temboury Ruiz F, Povar Marco J, Gich Saladich I. Short-term prognostic factors in elderly patients treated in emergency departments for acute coronary syndrome with ST segment elevation. Emergencias. 2011;23:455-60

Summary

Objective: To identify factors associated with short-term mortality in patients of

advanced age who come to the emergency department with acute coronary syndrome

with ST segment elevation.

Methods: Prospective longitudinal observational multicenter analytic study without

interventions. Patients aged 70 years or older who were treated at 42 Spanish hospitals

were included. Seventeen independent variables that might influence 30-day mortality

were analyzed. The information was extracted from the medical records or obtained

during interviews with the patient or a family member; it was then recorded in a

database developed for this study.

Results: A total of 1137 patients were included; 340 (29.9%) died within 30 days of the

emergency department visit. Four variables conferred significant risk of mortality. These

were age (odds ratio [OR], 2.71; 95% confidence interval [CI], 2.02-3.64); lack of

primary angioplasty (OR, 3; 95% CI, 1.32-6.81); advanced Killip class (OR, 10.19; 95%

CI, 6.99-14.85); and anterior location of the lesion (OR, 1.39; 95% CI, 1.03-1.86).

Conclusions: We identified several factors, such as age, that are recorded during

emergency department assessment and that predict poor short-term outcome in the

elderly patient treated for acute coronary syndrome with ST segment elevation.

Although Killip class, location of the acute myocardial infarction, and age cannot be

modified, we did identify a factor (performance of primary angioplasty) that, unlike

fibrinolytic treatment, is independently associated with a better outcome in terms of 30-

day mortality.

 

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