ObjectiveTo analyze hospitalized death related factors in elderly patients with nonST-segment elevation myocardial infarction (NSTEMI). MethodsThree hundred and two patients (≥65 years old) with NSTEMI were included. Thirty-two patients of them died in hospital (death group). Their clinical data were retrospectively analyzed and correlated factors for in-hospital death were evaluated. ResultsCompared with survival group, patients in death group were more likely to have 3 or more chronic diseases,heart function killip grades Ⅲ- Ⅳ, heart rate＞ 100/min and peripheral blood WBC count＞10X 10＜'9＞/L on admission (all P＜:0.05). There was no significant difference in fasting plasma glucose level and serum creatinine on admission between the two groups (both P:＞0.05). But after glomerular filtration rate(eGFR) were estimated by the modified abbreviated MDRD equations based on the Chinese CKD patients, patients in death group were more likely to be with renal dysfunction and pulmonary infection (both P＜0.01 ). Multiple logistic regression analysis showed that heart function killip grades Ⅲ-Ⅳ, renal dysfunction evaluated by eGFR, pulmonary infection on admission were the independent predictors for in-hospital death in elderly patients with NSTEMI. ConclusionsCoexistence of 3 or more chronic diseases is a related factor of death and heart function killip grades Ⅲ-Ⅳ, renal dysfunction evaluated by eGFR and pulmonary infection are the independent predictors for in-hospital death in elderly patients with NSTEMI.

Objective:To analyze the clinical characteristics and causes of death of 80 dead cases with confirmed coronavirus disease 2019 (COVID-19).Methods:The clinical data of 80 dead patients with COVID-19 who were admitted to Renmin Hospital of Wuhan University from January 11 to February 11, 2020 were retrospectively analyzed.The laboratory examination indexes (including white blood cells, lymphocytes, procalcitonin (PCT), lactic acid, D-dimmer, fibrinogen degradation products, N-terminal pro-brain natriuretic peptide (N-proBNP), ultra sensitive-troponin I, lactate dehydrogenase (LDH) and CD4 + T lymphocyte) of the patients at the time of admission were compared with the indexes at the last time before death. Statistical analysis was conducted by using paired t test or Wilcoxon′s signed rank test. Results:The median age was 72 years old of the 80 patients, and 78.75%(63/80) of them were older than 60 years. Thirty-six cases (45.00%) were severe and 44(55.00%) were critical at admission. Fifty-eight cases (72.50%) had underlying diseases. The common underlying diseases were hypertension, diabetes mellitus, coronary atherosclerotic heart disease, and chronic obstructive pulmonary disease. Comparing the patients′ first laboratory tests at admission with those before death, white blood cells increased (8.01(4.86, 12.29)×10 9/L vs 12.55(8.25, 17.66)×10 9/L), lymphocytes decreased (0.70(0.46, 0.88)×10 9/L vs 0.54(0.39, 0.75)×10 9/L), PCT increased (0.20(0.11, 0.74) μg/L vs 1.00(0.20, 1.99) μg/L), lactic acid increased (2.10(1.40, 3.10) mmol/L vs 3.10(2.60, 4.10) mmol/L), D-dimmer increased (4.33(0.97, 18.98) mg/L vs 15.29(5.17, 53.44) mg/L), fibrinogen degradation products increased (15.90(3.58, 76.60) mg/L vs 63.14(21.23, 110.67) mg/L), N-proBNP increased (1 078.00(347.35, 2 996.50) ng/L vs 3 439.50(1 576.00, 9 281.50) ng/L), ultra-sensitive troponin I increased (0.08(0.03, 0.17) μg/L vs 0.33(0.14, 2.47) μg/L), LDH increased (397.00(327.00, 523.50) U/L vs 624.00(481.00, 854.00) U/L) and CD4 + T lymphocyte decreased (137.00(104.00, 168.00)/μL vs 97.00(67.00, 128.00)/μL). The differences between the two groups were all statistically significant ( W=238.00, 1 053.50, 150.00, 152.00, 192.00, 190.00, 108.00, 57.00, 53.00 and 40.00, respectively, all P<0.05). All patients received antiviral and respiratory-support therapy and the main cause of death was respiratory failure caused by intractable hypoxemia and multiple organ failure. Among them, seven cases died in one day hospitalization, and 66 cases died in seven days hospitalization. Conclusions:Elderly patients with a variety of chronic underlying diseases have poor prognosis. It′s essential to pay more attention and deal with the above clinical characteristics at an early stage to improve the outcome of the COVID-19 patients.