Risk factors and prognosis of cardiogenic shock in elderly patients with acute myocardial infarction
10.3969/j.issn.1009-0126.2024.05.009
- VernacularTitle:老年急性心肌梗死患者并发心源性休克的危险因素及预后分析
- Author:
Haining LI
1
;
Wei CHEN
Author Information
1. 110044 沈阳市第十人民医院重症医学科
- Keywords:
myocardial infarction;
shock,cardiogenic;
risk factors;
prognosis;
retrospective studies
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(5):518-522
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors and prognosis of cardiogenic shock in elderly pa-tients with acute myocardial infarction(AMI).Methods A retrospective trial was conducted on 398 AMI patients admitted to our hospital from January 2020 to December 2023.Based on occur-rence of cardiogenic shock during hospitalization or not,they were divided into a cardiogenic shock group(n=99)and a control group(n=299).Clinical characteristics were compared between the two groups to analyze the risk factors of cardiogenic shock,and the impact of cardiogenic shock on the prognosis was investigated.Results The cardiogenic shock group had significantly larger pro-portions of aged ≥80 years,diabetes,coronary artery lesion ≥2 branches,left main coronary ar-tery disease,history of myocardial infarction than the control group(P＜0.05,P＜0.01).Aged 80 years,diabetes,diseased branches ≥2,left main artery disease and history of myocardial infarc-tion were independent influencing factors of cardiogenic shock in elderly AMI patients(OR=2.280,95％CI:1.294-4.017,P=0.004;OR=2.326,95％CI:1.281-4.225,P=0.006;OR=3.868,95％CI:2.145-6.975,P=0.000;OR=3.587,95％CI:1.868-6.886,P=0.000;OR=4.040,95％CI:1.951-8.365,P=0.000).Based on these relevant risk factors,a prediction model was constructed.The AUC value of the model in the training set was 0.799(95％CI:0.736-0.862),while the value for the validation set was 0.737(95％CI:0.634-0.840).Hosmer-Lemeshow Goodness of Fit test showed the model had good reliability(x2=7.117,P=0.524).The in-hospital mortality rate was significantly higher in the cardiogenic shock group than the control group(12.12％vs 0.67％,P=0.000).Conclusion Cardiogenic shock can lead to poor prognosis in elderly AMI patients.Aged ≥80 years,diabetes,diseased branches ≥2,left main ar-tery disease and history of myocardial infarction are independent risk factors for cardiogenic shock.
