SOBREVIDA A 30 DÍAS EN PACIENTES CON INFARTO AGUDO DE MIOCARDIO QUE RECIBEN ATENCIÓN EN UN HOSPITAL DE SEGUNDO NIVEL

Abstract

“THIRTY DAY SURVIVAL IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WHO ARE ATTENDED IN A LEVEL TWO HOSPITAL” One of the most common diseases seen in the emergency department acute myocardial infarction (AMI) the problem of survival has several approaches. The delay in receiving medical care at any stage can motivate the presentation of complications and limiting the use of thrombolytic drugs that are used immediately, this study examined whether cardiovascular risk factors and socio-economics well as forecast scores are directly related to mortality in patients with acute myocardial infarction. Objective: To determine the thirty day survival of patients with Acute Myocardial Infarction (AMI) who are attended in a level two hospital and the factors associated with mortality. Materials and methods: An observational, transverse, descriptive and prospective study in the Emergency Department of the Regional General Hospital -1 of Orizaba, Veracruz, México. Data collected from January 1 through to September 30th, 2010. The sample was non-probabilistic for convenience in patients with and without social security who arrived at the Emergency Department and who were diagnosed with acute myocardial infarction. Results: The study sample consisted of 60 patients of whom gender, age, occupation, marital status, socio-economic class, BMI, presence of sedentary lifestyle, diabetes, hypertension, cigarette smoking, dyslipidemia, electro-mechanical complications of AMI, localization of infarct, application of thrombolytics, time to treatment, and TIMI and Killip-Kimball scores were recorded. Of the total sample, 66.6% (40) presented STEMI and 33.33% (20) presented NSTEMI. Of all risk factors, those that had a significant direct effect upon mortality and thirty day survival were age – with greater mortality associated with greater age, followed by patients with a previous history of arterial hypertension who arrived at the emergency service with hypotension or cardiogenic shock. High TIMI risk scores for STEMI and NSTEMI were also associated with higher mortality. Conclusions: The thirty day survival is low, 55%, with a mortality of 45% and solely indirectly reflects deficiencies in the opportune attention that patients receive during the pre-hospital, hospital and post-hospital phases.