Predictors of prolonged hospital stay and in-hospital mortality in female patients with acute myocardial infarction with specific reference to diabetes.

Autor: Shalaby G; Cardiology- Zagazig University- Egypt, King Abdullah Medical City, Muzdallfa Road, Makkah, Saudi Arabia. Electronic address: ghadashalaby10@gmail.com., Sabri S; Alahrar teaching hospital- Zagazig-Egypt, King Abdullah Medical City, Muzdallfa Road, Makkah, Saudi Arabia., Alsilami ANS; Umm al-Qura Unuversity- faculty of medicine, Al-Awali, Mecca 24381, Saudi Arabia., Alhassani RY; Umm al-Qura Unuversity- faculty of medicine, Mecca, Saudi Arabia., Alsayed SH; Umm al-Qura Unuversity- faculty of medicine, Mecca, Saudi Arabia., Alhazmi MAW; Alnoor hospital, Makkah, Saudi Arabia., Aoudallah MT; King Abdullah Medical City, Makkah, Saudi Arabia., Khaled S; cardiology- Banha University Egypt, King Abdullah Medical City, Muzdallfa Road, Makkah, Saudi Arabia.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2024 Apr 01; Vol. 400, pp. 131785. Date of Electronic Publication: 2024 Jan 17.
DOI: 10.1016/j.ijcard.2024.131785
Abstrakt: This study aimed to determine predictors of prolonged length of stay (LOS) and mortality in female STEMI patients with diabetes in comparison to female STEMI patients without diabetes. This retrospective single-center study was conducted between 2015 and 2020 as part of the STEMI registry in our center and included all STEMI patients. RESULTS: Out of 3081 STEMI patients, 16% (N = 498) were female, and 64% (n = 318) of them had diabetes. Diabetic patients were less commonly presented with anterior wall myocardial infarction (AWMI) (47% vs 65%, p = 0.001), but tended to have a higher prevalence of left main (LM) significant disease compared to non-diabetic patients (4% vs 1%, p = 0.06). Of the patients, 36% had prolonged LOS (≥5 days), and they were more obese with a higher incidence of hemoglobin drop ≥ 3 g/dL, higher admission troponin, and peak creatinine. 22% of patients with prolonged LOS came to the hospital after receiving lytic therapy and showed a higher prevalence of multivessel stenosis. Prolonged LOS patients had a higher incidence of pulmonary edema and cardiac arrest, which necessitated ventilation, although they did not show a significant difference in mortality from the group with LOS < 5 days. Our study found a significant negative correlation between glycosylated hemoglobin (HbA1c) and left ventricular ejection fraction (LVEF) (p = 0.02), but a positive correlation was noticed between HbA1c and LOS (p < 0.001). Regression analysis showed that diabetes mellitus, hemoglobin drop, creatinine level, and LVEF were significant predictors of prolonged LOS among females, although HbA1c, BMI ≥ 30, STEMI type, and peak creatinine level were independent predictors of prolonged LOS among female diabetic patients. Age ≥ 65 years and LVEF were significant independent predictors of mortality (p = 0.04, 0.02 respectively) in STEMI female patients. CONCLUSIONS: Diabetes mellitus, bleeding, renal impairment, and LVEF were found to be significant independent predictors of prolonged LOS among STEMI females. Age ≥ 65 years and LVEF were significant predictors of mortality among STEMI female patients.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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