在ST升高肌肉梗塞的非老年人中,临床结果和出院倾向
Janki Shukla1, Christian Schmidt2, David Larson2
1University of Cincinnati, College of Medicine, Cincinnati, OH.
American heart journal
|June 29, 2025
概括
患有ST升高心肌梗塞 (STEMI) 的非老年人面临更高的死亡率. 住院前后的生活状况对结果产生重大影响,熟练护理机构居民的预后更差.
科学领域:
- 心脏病学 心脏病学
- 老年医学 老年医学
- 公共卫生 公共卫生
背景情况:
- 患有ST升高心肌梗塞 (STEMI) 的非老年人 (≥90岁) 是临床试验中代表性不足但不断增长的人群.
- 由于过去的研究中存在任意排除标准,了解这一人口群体中的STEMI管理至关重要.
研究的目的:
- 检查经历STEMI的非老年人的结果.
- 为了确定预后因素,特别关注住院前后的生活状况,在这个老年人群中.
主要方法:
- 一项队列研究分析了中西部STEMI联盟数据库 (2003年3月至2020年10月) 的数据.
- 在症状出现后24小时内出现STEMI的患者被纳入,无论年龄,休克或心脏骤停状态如何.
- 数据按年龄组分层 (<70,70-79,80-89,≥90岁),结果包括住院,30天和1年间隔的出院处置和死亡率.
主要成果:
- 在15039名STEMI患者中,303人 (2%) 是非老年人,64%是女性.
- 非老年人的住院,30天和1年的死亡率分别为17%,20%和33%.
- 在出现之前居住在熟练护理设施 (SNF) 的患者在住院死亡率 (36%) 与居住在家或辅助生活设施 (ALF) (14-15%) 相比显著更高. 在被送往SNF的患者中,一年死亡率为43%,而在被送回家的患者中为13% (P < .001).
结论:
- 在STEMI呈现之前,生活在SNF中与住院死亡率相比,在家生活的两倍以上有关.
- 与排放家相比,排放到SNF导致1年死亡率增加了三倍.
- 退院前和退院后的生活状况是老年STEMI患者的关键预后指标.
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