Mu'taz Dreidi, Imad Asmar, Maram Jaghama, Intima Alrimawi, Maha Atout
{"title":"Electrolyte Imbalance Among Patients With and With No ST-Elevation Myocardial Infarction: A Cohort Study.","authors":"Mu'taz Dreidi, Imad Asmar, Maram Jaghama, Intima Alrimawi, Maha Atout","doi":"10.1097/CNQ.0000000000000446","DOIUrl":null,"url":null,"abstract":"<p><p>Electrolytes imbalances are highly prevalent and have shown a high impact on mortality in patients with acute myocardial infarction. These electrolytes imbalance have prognostic value in predicting mortality in patients with acute myocardial infarction. The purpose of this study was to assess the prognostic value of electrolyte imbalances in predicting 1-month mortality among patients with myocardial infarction with and with no ST-elevation. This cohort study was conducted in a referral hospital in the West Bank, Palestine. All patients with confirmed medical diagnosis of acute myocardial infarction and admitted to the medical coronary care unit in the hospital were eligible participants. A convenience sample of 186 participants was obtained. These participants were followed up for 1 month to assess their survival (alive or dead). Demographic and clinical data were recorded by reviewing their health records. The derived data were analyzed using SPSS version 19. About 36% of all patients were found to be hyponatremic, 15% of them have hypokalemia, and 9% of patients had hypocalcemia. There was a significant difference between STEMI and non-STEMI in sodium (t = 4.7, P < .001). A multivariate logistic regression analysis was performed to predict 1-month mortality for patients with myocardial infarction with and with no ST-elevation. The predictors that were found to be significant are sodium (odds ratio [OR] = 0.789, P = .010), calcium (OR = 0.221, P = .014), diastolic blood pressure (OR = 0.933, P = .047), and blood urea nitrogen (OR = 0.821, P = .005). Electrolyte imbalance was highly prevalent among patients with acute myocardial infarction. Hyponatremia and hypocalcemia were present and associated significantly with predicting 1-month mortality. Health care providers should take into consideration the electrolytes of patients with acute myocardial infarction from the first moment of admission and correct them early to maximize the clinical outcomes and survival for patients.</p>","PeriodicalId":10789,"journal":{"name":"Critical Care Nursing Quarterly","volume":"46 2","pages":"136-144"},"PeriodicalIF":1.0000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Care Nursing Quarterly","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/CNQ.0000000000000446","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Electrolytes imbalances are highly prevalent and have shown a high impact on mortality in patients with acute myocardial infarction. These electrolytes imbalance have prognostic value in predicting mortality in patients with acute myocardial infarction. The purpose of this study was to assess the prognostic value of electrolyte imbalances in predicting 1-month mortality among patients with myocardial infarction with and with no ST-elevation. This cohort study was conducted in a referral hospital in the West Bank, Palestine. All patients with confirmed medical diagnosis of acute myocardial infarction and admitted to the medical coronary care unit in the hospital were eligible participants. A convenience sample of 186 participants was obtained. These participants were followed up for 1 month to assess their survival (alive or dead). Demographic and clinical data were recorded by reviewing their health records. The derived data were analyzed using SPSS version 19. About 36% of all patients were found to be hyponatremic, 15% of them have hypokalemia, and 9% of patients had hypocalcemia. There was a significant difference between STEMI and non-STEMI in sodium (t = 4.7, P < .001). A multivariate logistic regression analysis was performed to predict 1-month mortality for patients with myocardial infarction with and with no ST-elevation. The predictors that were found to be significant are sodium (odds ratio [OR] = 0.789, P = .010), calcium (OR = 0.221, P = .014), diastolic blood pressure (OR = 0.933, P = .047), and blood urea nitrogen (OR = 0.821, P = .005). Electrolyte imbalance was highly prevalent among patients with acute myocardial infarction. Hyponatremia and hypocalcemia were present and associated significantly with predicting 1-month mortality. Health care providers should take into consideration the electrolytes of patients with acute myocardial infarction from the first moment of admission and correct them early to maximize the clinical outcomes and survival for patients.
电解质失衡非常普遍,并对急性心肌梗死患者的死亡率有很大影响。这些电解质失衡对预测急性心肌梗死患者的死亡率具有预后价值。本研究的目的是评估电解质失衡在预测伴有和不伴有st段抬高的心肌梗死患者1个月死亡率中的预后价值。这项队列研究在巴勒斯坦西岸的一家转诊医院进行。所有经医学诊断为急性心肌梗死并在医院冠状动脉内科就诊的患者均为合格的参与者。获得了186名参与者的方便样本。随访1个月,评估患者的生存情况(存活或死亡)。通过审查他们的健康记录,记录了人口统计和临床数据。导出数据采用SPSS version 19进行分析。所有患者中约36%为低钠血症,15%为低钾血症,9%为低钙血症。STEMI患者与非STEMI患者钠含量差异有统计学意义(t = 4.7, P < 0.001)。采用多变量logistic回归分析预测伴有和不伴有st段抬高的心肌梗死患者的1个月死亡率。钠(比值比[OR] = 0.789, P = 0.010)、钙(OR = 0.221, P = 0.014)、舒张压(OR = 0.933, P = 0.047)和血尿素氮(OR = 0.821, P = 0.005)是具有显著意义的预测因子。电解质失衡在急性心肌梗死患者中非常普遍。存在低钠血症和低钙血症,并与预测1个月死亡率显著相关。医护人员应从入院第一时间就考虑急性心肌梗死患者的电解质,并尽早纠正,以最大限度地提高患者的临床疗效和生存率。
期刊介绍:
Critical Care Nursing Quarterly (CCNQ) is a peer-reviewed journal that provides current practice-oriented information for the continuing education and improved clinical practice of critical care professionals, including nurses, physicians, and allied health care professionals.