急性心肌梗死并发心脏骤停患者的短期和长期预后:2013-2022 年全国范围内的队列研究。

IF 3.9 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Jarle Jortveit, Geir Øystein Andersen, Sigrun Halvorsen
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引用次数: 0

摘要

目的:在全国范围内进行队列研究,评估院外心脏骤停(OHCA)或院内心脏骤停(IHCA)并发急性心肌梗死(AMI)的短期和长期预后:方法:对2013-2022年挪威医院收治的、在挪威心肌梗死登记处登记的AMI患者进行队列研究。研究结果为院内死亡率和长期死亡率。累积死亡率采用卡普兰-梅耶法和生命表法进行评估。Cox回归用于风险比较:在105,439名AMI患者中(35%为女性),我们发现了3,638名(3.5%)OHCA患者和2,559名(2.4%)IHCA患者。OHCA、IHCA 和无心脏骤停 (CA) 的 AMI 患者的平均年龄分别为 65.7 (13.2)、70.9 (12.6) 和 70.7 (13.6)岁。中位随访时间为 3.3 年(第 25、75 百分位数;1.1、6.3)。OHCA、IHCA和无CA的AMI的院内死亡率分别为28%、49%和5%,估计5年累积死亡率分别为48%(95% CI 46-50%)、69%(95% CI 67-71%)和35%(95% CI 34-35%)。在出院后存活的患者中,OHCA和无CA的AMI患者在随访期间的死亡率无明显差异(调整后危险比(HR)1.04,95% CI 0.96-1.13),而IHCA的AMI患者的长期死亡率更高(年龄调整后HR 1.31,95% CI 1.19-1.45):结论:在这一大型当代急性心肌梗死患者队列中,OHCA 或 IHCA 患者的院内死亡率仍然很高。在出院后存活的患者中,OHCA和无CA的AMI患者的长期死亡率相当,而IHCA患者的预后明显较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Short- and long-term outcomes of patients with acute myocardial infarction complicated by cardiac arrest: A nationwide cohort study 2013-2022.

Aim: To assess short- and long-term outcomes of acute myocardial infarction (AMI) complicated by out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA) in a nationwide cohort.

Methods: Cohort study of AMI patients admitted to hospitals in Norway 2013-2022 registered in the Norwegian Myocardial Infarction Registry. Outcomes were in-hospital and long-term mortality. Cumulative mortality was assessed with the Kaplan-Meier and the Life-table methods. Cox regression was used for risk comparisons.

Results: Among 105,439 AMI patients (35% women), we identified 3,638 (3.5%) patients with OHCA and 2,559 (2.4%) with IHCA. The mean age was 65.7 (13.2), 70.9 (12.6) and 70.7 (13.6) years for OHCA, IHCA, and AMI without cardiac arrest (CA), respectively. The median follow-up time was 3.3 (25th, 75th percentile; 1.1, 6.3) years. In-hospital mortality was 28%, 49% and 5%, in OHCA, IHCA and AMI without CA, and estimated 5-year cumulative mortality was 48% (95% CI 46-50%), 69% (95% CI 67-71%), and 35% (95% CI 34-35%), respectively. Among patients surviving to hospital discharge, no significant difference in mortality during follow-up was found between OHCA and AMI without CA (adjusted Hazard Ratio (HR) 1.04, 95% CI 0.96-1.13), while the long-term mortality of AMI patients with IHCA was higher (age-adjusted HR 1.31, 95% CI 1.19-1.45).

Conclusion: In this large, contemporary cohort of AMI patients, in-hospital mortality of patients with OHCA or IHCA was still high. Among patients surviving to hospital discharge, long-term mortality was comparable between OHCA and AMI without CA, while the outcome of patients with IHCA was significantly worse.

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来源期刊
CiteScore
8.50
自引率
4.90%
发文量
325
期刊介绍: The European Heart Journal - Acute Cardiovascular Care (EHJ-ACVC) offers a unique integrative approach by combining the expertise of the different sub specialties of cardiology, emergency and intensive care medicine in the management of patients with acute cardiovascular syndromes. Reading through the journal, cardiologists and all other healthcare professionals can access continuous updates that may help them to improve the quality of care and the outcome for patients with acute cardiovascular diseases.
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