Risk factors related to in-hospital mortality in patients with nontraumatic myocardial injury presenting to the emergency department
- Author:
Dowon LEE
1
;
Haewon JUNG
;
Hyun Wook RYOO
;
Jae Yun AHN
;
Sungbae MOON
;
Kang Suk SEO
;
Jungbae PARK
Author Information
1. Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Publication Type:Original Article
- From:Journal of the Korean Society of Emergency Medicine
2026;37(1):10-19
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:To identify clinical factors associated with in-hospital mortality among patients presenting to the emergency department (ED) with nontraumatic myocardial injury.
Methods:This retrospective observational study included adult patients who visited a single ED from January to December 2022 and had elevated high-sensitive troponin I levels above the 99th percentile. Patients with trauma, cardiac arrest, transfers, or do-not-resuscitate status were excluded. Data on the demographics, vital signs, mental status, comorbidities, and final ED diagnoses were analyzed using multivariable logistic regression analysis.
Results:Among 989 patients, 117 (11.8%) died during hospitalization. The respiratory rate ≥25/min (adjusted odds ratio [aOR], 5.39; 95% confidence interval [CI], 1.65-6.59), respiratory rate 21-24/min (aOR, 3.30; 95% CI, 2.64-11.02), and SpO2 <91% (aOR, 5.47; 95% CI, 2.73-10.95) were significantly associated with mortality. Comorbidities, including coronary artery disease (aOR, 2.78; 95% CI, 1.47-5.26), respiratory disease (aOR, 2.89; 95% CI, 1.18-7.15), and malignancy (aOR, 2.91; 95% CI, 1.18-7.15), were also independent predictors. Compared to a type 1 myocardial infarction, the final ED diagnoses of infectious diseases (aOR, 31.88; 95% CI, 11.59-87.72), neoplasms (aOR, 6.71; 95% CI, 2.51-17.94), and cerebrovascular diseases (aOR, 4.76; 95% CI, 1.75-11.46) were associated with higher mortality.
Conclusion:In patients with nontraumatic myocardial injury presenting to the ED, respiratory abnormalities, coronary artery diseases, respiratory diseases and malignancy were independently associated with in-hospital mortality, while final ED diagnoses of infection, neoplasm, and cerebrovascular disease were associated with a higher risk of mortality compared to type 1 myocardial infarction.
