Multivariate analysis in the prediction of death in hospital after acute myocardial infarction.

Abstract

Prognostic factors in patients with acute myocardial infarction based on clinical and investigative data on admission were evaluated prospectively in 111 consecutive patients. Seventeen patients (15.3%) died during hospital stay. Age, a previous infarct, high Killip class, cardiomegaly, high serum concentrations of cardiac enzymes, a low ejection fraction, and a high wall motion score index correlated significantly with in-hospital mortality; whereas sex, risk factors, and pericardial effusion did not. Multivariate analysis showed that age and the wall motion score index were the best predictors of death in hospital. Wall motion detected by cross sectional echocardiography may reflect the extent of myocardial involvement. Age and wall motion score index predicted in-hospital mortality with a sensitivity of 76.5%, a specificity of 91.5%, and a predictive accuracy of 89.2%. Age and the wall motion score index can be determined on admission and are useful for identifying patients at high risk of cardiac death who might benefit from early intervention.

Is female sex an independent predictor of in-hospital mortality in acute myocardial infarction?

“…As in most studies 40,41 , advanced age proved to be an important independent predictive factor of mortality. This piece of information is easily obtained and may identify high-risk patients, who may benefit from a more aggressive therapy.…”

Complicação infecciosa indica mau prognóstico no infarto agudo do miocárdio

“…This index or score is based on variables obtained during hospitalization. According to more recent studies, in-hospital mortality in acute myocardial infarction is directly related to feminine gender, older age, previous history of infarction, anterior wall AMI, extension of the ischemic area, signs of significant left ventricular dysfunction, and arterial hypotension [11][12][13][14][15] .…”

Risk Stratification after Acute Myocardial Infarction by Means of Echocardiographic Wall Motion Scoring and Killip Classification

“…Both the insignificant difference in WMI and the significant difference in mortality could be explained by the significant difference in age between men and women. In a recent study, both age and WMI were shown to contain independent prognostic information [21], WMI divided the population into a defi nite low risk group (WMI > 1.3) and a medium/high risk group (fig. 1).…”