Acute, Severe Noncardiac Conditions in Patients with Acute Myocardial Infarction.
From: Section of Chronic Disease Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn 06520-8088, USA.
The American journal of medicine
- Publish Date: Oct 2006
- ISSN: 1555-7162
- Volume: 119
- Issue: 10
- Pages: 843-50
- Medium: Internet
- Language: English
- Citation (JAMA): Lichtman Judith H, Fathi Amir, Radford Martha J, et al. Acute, Severe Noncardiac Conditions in Patients with Acute Myocardial Infarction.. Am. J. Med. Oct 2006;119:843-50
Abstract
PURPOSE: The study’s purpose was to determine the prevalence and prognostic importance of acute, severe, noncardiac conditions present at the time of an acute myocardial infarction (AMI). METHODS: We identified consecutive patients with AMI who were discharged from Yale-New Haven Hospital between January 1, 1997, and June 30, 2000. Acute, noncardiac conditions that were present at admission were abstracted from patient records and graded by severity (imminent threat to life; other significant condition that would warrant admission). We examined the prognostic importance of these conditions on hospital mortality in multivariable logistic models. The study included 1145 patients with AMI, of whom 8.5% (n=97) presented with an acute, life-threatening, noncardiac condition at admission and 19.5% (n=223) presented with another significant noncardiac condition. RESULTS: Hospital mortality was 25.8% and 9.0%, respectively, for patients who presented with life-threatening and other significant noncardiac conditions, compared with 4.6% for patients without either of these conditions. In multivariable analysis, life-threatening noncardiac conditions were associated with increased hospital mortality after adjusting for demographic factors, medical history, clinical presentation, cardiac severity, and initial therapy (odds ratio 2.5; 95% confidence interval [CI], 1.2-5.2). No increased hospital mortality risk was found for other significant noncardiac conditions in the risk-adjusted analyses (odds ratio 1.0; 95% CI, 0.5-1.7). CONCLUSIONS: A subgroup of patients with AMI presented with a life-threatening noncardiac condition, which was associated with a marked increase in the risk of death during the hospitalization. Despite the excessive mortality risk associated with concomitant noncardiac conditions, this subset of patients with AMI are poorly described in current literature.
Mesh Headings (Keywords): Acute Disease, Aged, Comorbidity, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction, Prevalence, Prognosis, Retrospective Studies, Risk Factors, Severity of Illness Index
Check for Full Text / PubMed Unique Identifier (PMID): 17000215
This abstract is part of PubMed, a service of the U.S. National Library of Medicine. PubMed includes more than 17 million citations from MEDLINE and other life science journals for biomedical articles. See Copyright and Disclaimers.
Linked medical terms appearing on this page are added by Healia to help readers find more information and are not part of the original PubMed document.
The data herein was last updated on July 8th, 2008 and may not reflect the most current and accurate data available from NLM.