Acute coronary syndrome, comorbidity, and mortality in geriatric patients
E Taneva1, V Bogdanova, N Shtereva
1Clinic of Cardiology, Intensive Care, Medical University, Sofia 1431, Bulgaria. etaneva_md@yahoo.com
Insights
Geriatric patients admitted for acute coronary syndrome often have multiple supporting diseases, increasing mortality risk. Early onset of acute coronary syndrome in the elderly frequently leads to multiorgan failure.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- Heart disease is a leading cause of morbidity and mortality in geriatric patients.
- These elderly patients frequently present with multiple supporting diseases (comorbidities).
- Acute coronary syndrome (ACS), encompassing unstable angina and myocardial infarction, is a critical concern in this demographic.
Purpose of the Study:
- To conduct a retrospective morbidity analysis of geriatric patients admitted to the emergency department with acute coronary syndrome.
- To investigate the prevalence of comorbidities and their impact on mortality in elderly ACS patients.
- To identify common comorbidities and their combinations in this high-risk population.
Main Methods:
- Retrospective analysis of 588 patients admitted between 1998 and 2000.
- Patients were categorized by age (65-75 and >75 years) and sex.
- Comorbidity and mortality data were collected and analyzed.
Main Results:
- The majority of geriatric patients (68.53%) had three or more supporting diseases.
- Common comorbidities included heart failure, endocrinological diseases (diabetes, obesity), neurological diseases (stroke), and chronic kidney disease.
- The combination of hypertension, heart failure, and type 2 diabetes was most frequent.
- Mortality rates increased over the study period, with a significant 66.6% mortality within the first 12 hours of ACS onset.
Conclusions:
- Geriatric patients with acute coronary syndrome present with significant comorbidity burdens.
- Multiorgan failure is common at the onset of ACS in the elderly.
- Elderly patients with ACS represent a high-risk group requiring intensive coronary care.
Abstract:
Morbidity and mortality rates from heart diseases are highly represented in geriatric-aged patients, but these patients also have supporting diseases. Acute coronary syndrome includes unstable angina and acute myocardial infarction with and without ST elevation. The aim of this study was to make a retrospective morbidity analysis of patients admitted to the emergency department. The study is made for a period of three years (from 1998 to 2000). It includes 588 patients divided by age (395 were 65-75 years old; 193 were older than 75 years) and sex (there were 326 men and 262 women). Comorbidity and mortality were investigated. Patients with one, two, three, and more than three supporting diseases were 6.29%, 23.13%, 68.53%, and 2.04%, respectively, of the total number. The most frequent geriatric patients had heart failure, followed by endocrinological diseases (type 2 diabetes, obesity, struma), neurological diseases (insultus, paresis), and chronic kidney diseases (pielonephritis, nephrolithiasis). The combination of hypertension, heart failure, and type 2 diabetes had the highest comorbidity frequency. The mortality rate for 1998 was 8.81%, for 1999 7.74%, and for 2000 13.41%. The mortality rate at the first 12 hours at the beginning of the acute coronary syndrome was 66.6%. Geriatric patients suffer from many diseases, and at the beginning of the onset of acute coronary syndrome they have multiorganal failure. Elderly patients are a high-risk contingent in intensive coronary care units.
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