Predictors of in-hospital mortality in very very eldery patients presented with acute coronary syndrome; A single center study

Yılmaz, Samet; Adalı, Mehmet Koray; Kilic, Oguz; Til, Ayşen; Yaylali, Yalın Tolga; Dursunoğlu, Dursun; Kaftan, H. Asuman

doi:10.5543/tkda.2018.68792

Cited by 7 publications

(6 citation statements)

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“…These results included but were not limited to elderly patients. Among causes of death in the very elderly population with ACS, cardiogenic shock, and acute renal failure are the most prevalent culprits reported 13 . Despite the KC being classic and simple, research around it has prevailed and many centers continue to use it for clinical profile classification purposes.…”

Section: Discussionmentioning

confidence: 99%

Clasificación de Killip-Kimball en octogenarios con síndrome coronario agudo: 11 años de experiencia

Ramonfaur¹,

Hinojosa-González²,

Paredes-Vázquez³

2022

ACM

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Objective:The objective of the study is to validate the use of the Killip-Kimball classification (KC) as a predictor of outcomes in an octogenarian cohort with acute coronary syndrome. Methods: A retrospective analysis of patients who underwent a catheterization procedure for acute coronary syndrome (ACS) was performed. ACS was defined as per the American Heart Association guidelines, and included ST-elevation myocardial infarction (STEMI), non-STEMI and Unstable Angina. We determined factors associated with the KC upon admission ¡ to the emergency room. Likewise, we compared in-hospital mortality, length of stay, and other outcomes dividing the patients by KC. Results: A total of 133 patients with a mean age of 83 years were analyzed and assigned a KC from 1 to 4 according to clinical presentation. Each group included 86,9, 23, and 15 patients, and 40% in KC-IV with a significant difference between classes (p = 0.002). In addition, we found higher KC groups to be associated with acute kidney injury during the hospitalization (p < 0.01). Conclusion: Despite a strong reduction in mortality for elderly patients with ACS in recent decades, patients presenting with ACS and higher KC have a high mortality rate, as described in younger cohorts. KC remains a reliable prognostic tool, with applicability in octogenarian patients.

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Section: Discussionmentioning

confidence: 99%

Clasificación de Killip-Kimball en octogenarios con síndrome coronario agudo: 11 años de experiencia

Ramonfaur¹,

Hinojosa-González²,

Paredes-Vázquez³

2022

ACM

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“…Amongst causes of death in the very elderly population with ACS, cardiogenic shock and acute renal failure are most important culprits reported. (13) Despite the Killip and Kimball classification being an old and simple scoring system, research around this classification has prevailed and many centers continue to use it for clinical profile classification purposes. A landmark contribution made in 2019 by Zadok and collaborators demonstrated statistical significance in both short- and long-term mortality in patients with higher KC.…”

Section: Discussionmentioning

confidence: 99%

Killip-Kimball Classification Validation, Outcomes and Demographics in an Octogenarian Cohort with Acute Coronary Syndrome in a Developing Country: A Third-Level Multicenter 11-Year Experience

Ramonfaur

Hinojosa-González

Paredes-Vázquez

2020

Preprint

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Introduction: The Killip-Kimball Classification (KC) is used to group patients with acute coronary syndrome (ACS) based on their clinical profile. It has proven to be useful while predicting both short- and long-term mortality. Contemporary data in the elderly population is limited. We sought to analyze trends in outcomes of patients 80 years or older admitted for ACS, by Killip Class. In addition, we assess the validity of the KC in this population. Methodology: A retrospective analysis of patients who underwent a catheterization procedure for ACS was performed. ACS was defined as per AHA guidelines, and included STEMI, non-STEMI and Unstable Angina. We determined factors influencing the KC in which patients present to the emergency room. Likewise, we compared in-hospital mortality, length of stay, and other outcomes dividing the patients by KC. Results: A total of 133 patients were analyzed. Included were: 86, 9, 23 and 15 patients in KC-I through IV respectively with a mean age of 83. The main comorbidities were hypertension (73%), and diabetes (43%). In-hospital mortality was 12%, which was different between KC groups (p< 0.01). In addition, we found higher KC groups to be associated with acute kidney injury during the hospitalization (p< 0.01). Conclusion: Despite a strong reduction in mortality for elderly patients with ACS in recent decades, patients presenting with ACS and higher Killip class have a high mortality rate, as described in younger cohorts. The Killip-Kimball classification remains a reliable prognostic tool, with applicability in octogenarian patients.

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“…Yine başka bir çalışmada AKS tanısı ile yatırılan 80 yaş ve üzeri hastalarda yüksek GRACE risk skoru, öncesinde anjiotensin dönüştürücü enzim inhibitörü/anjiotensin reseptör inhibitörü (ACEI/ARB) kullanımı ve başvuru anında düşük ejeksiyon fraksiyonunun hastane içi mortalite ile ilişkili olduğu görülmüştür. Aynı zamanda zirve troponin değerinin ölen hastalarda, yaşayan hastalara göre anlamlı olarak daha fazla olduğu tespit edilmiştir 15…”

Section: Yöntemlerunclassified

ST Segment Yükselmesiz Akut Koroner Sendromlu Yaşlı Hastalarda Girişimsel Tedavi ile Konservatif Tedavinin Altı Aylık Dönemde Mortalite Üzerine Etkilerinin Karşılaştırılması

Işık¹

2021

Dicle Tıp Dergisi

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Giriş: Çalışmamızın amacı, ST segment yükselmesiz akut koroner sendrom (NSTEAKS) tanısı ile hastaneye yatırılan yaşlı (65 yaş ve üstü) hastalarda girişimsel tedavi ve konservatif tedavi gruplarının 6 aylık dönemde mortalitelerini karşılaştırmaktır.Yöntemler: Çalışmamızda NSTEAKS tanısı ile hastaneye yatırılan 65 yaş ve üstü ardışık 300 hasta retrospektif olarak incelendi. Hastane kayıt sisteminden tüm hastaların verilerine ulaşıldı. Hastalar girişimsel tedavi alanlar ve konservatif tedavi verilenler olarak iki gruba ayrıldı. Ayrıca 6 aylık süreçte ölen hastalar ve yaşayan hastalar, iki grup olarak karşılaştırıldı.Bulgular: Çalışmaya alınan hastaların yaş ortalaması 74.72 ± 6.42 olup 157'si (%52) kadındı. Girişimsel ve konservatif tedavi grubunun yaş ortalamaları benzerdi (73.67 ± 5.92 vs 75.77 ± 6.78, p=0.05). Çalışma popülasyonunda 6 aylık dönemde mortalite oranı %13,6 idi. Girişimsel tedavi gurubunda mortalite anlamlı olarak daha düşüktü (%8,6 vs %18,6, p= 0.018). Çalışmamızda, çok değişkenli lojistik regresyon analizi ile 6 aylık mortalitede bazı öngördürücüler tespit ettik. Bunlar; çok yüksek CRUSADE kanama riski [Odds oranı (OR): 1.911, güven aralığı (GA) %95 (1.964 -28.186), p= 0.030)], konservatif tedavi stratejisinin benimsenmesi [OR: 1.127, GA %95 (0.131 -0.799), p= 0.014)] ve kardiyak biyobelirteçlerinin (troponin) pozitifliğiydi [OR: 1.837, GA %95 (1.928 -25.391), p= 0.030)].Sonuç: Yaşlı NSTEAKS hastalarında 6 aylık mortaliteyi öngörmede konservatif tedavi stratejisi bağımsız bir prediktördür. Başka ifade ile girişimsel tedavi yapılması, yaşlı hastalarda mortaliteyi azaltmıştır. Bu sonuçlar yaşlı hastaların da kapsamlı bir değerlendirmeden sonra girişimsel tedaviden fayda görebileceğini göstermektedir.

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Predictors of in-hospital mortality in very very eldery patients presented with acute coronary syndrome; A single center study

Cited by 7 publications

References 0 publications

Clasificación de Killip-Kimball en octogenarios con síndrome coronario agudo: 11 años de experiencia

Clasificación de Killip-Kimball en octogenarios con síndrome coronario agudo: 11 años de experiencia

Killip-Kimball Classification Validation, Outcomes and Demographics in an Octogenarian Cohort with Acute Coronary Syndrome in a Developing Country: A Third-Level Multicenter 11-Year Experience

ST Segment Yükselmesiz Akut Koroner Sendromlu Yaşlı Hastalarda Girişimsel Tedavi ile Konservatif Tedavinin Altı Aylık Dönemde Mortalite Üzerine Etkilerinin Karşılaştırılması

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