Abstract:

Analysis of risk factors in elderly patients with multiple organs dysfunction syndrom following acute myocardial infarctionXIONG Ri-cheng, GUO Zhen-hui, YU Zhou, SUN Jie. Department of Medical Intensive Care Unit, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010,China
【Ａｂｓｔｒａｃｔ】　ＯｂｊｅｃｔｉｖｅTo explore the risk factors in elderly patients with multiple organs dysfunction syndrom (MODS) following acute myocardial infarction.ＭｅｔｈｏｄｓThe clinical data of 260 acute myocardial infarction patients admitted from May 2003 to April 2008 were retrospectively analyzed based on the prognosis. Therapeutic strategies were compared between acute myocardial infarction group(n=207) and acute myocardial infarction complicated with MODS group(n=53). Risk factors affecting MODS following acute myocardial infarction in terms of treatment were analyzed using logistic analysis.ＲｅｓｕｌｔｓThe incidence of MODS following acute myocardial infarction was 20.4％. No significant difference between two groups in the clinical feature was found. Therapeutic strategies adopted in the acute myocardial infarction group included electrocardiogram monitoring(97.1％, 201／207), sterile operative technique (97.6％,202／207), psychotherapy(85.5％,177／207), anti-platelet combining with two drugs(95.2％,197／207), anticoagulation (83.1％,172／207), percutaneous coronary interventions (80.2％,166／207)and mechanical ventilation (10.1％, 21／207). And the rates of these therapeutic strategies adopted in the acute myocardial infarction complicated with MODS group were 90.6％(48／53), 88.7％(47／53), 73.6％(39／53), 86.8％(46／53), 69.8％(37／53)、60.4％(32／53)and 37.7％(20／53) respectively. These application rates of these therapeutic atrategies in the acute myocardial infarction group were significantly higher than those in the acute myocardial infarction complicated with MODS group (P＜0.05). However, there was no significant difference in β adrenergic blocking agent, the use of ACEI／ARB and intensive insulin therapy between two groups. And the main risk factors were electrocardiogram monitoring, percutaneous coronary interventions and mechanical ventilation (OR:0.254, 0.447 and 6.515 respectively, all P＜0.05).ＣｏｎｃｌｕｓｉｏｎｓThe mortality of acute myocardial infarction patients complicated with MODS is high. Electrocardiogram monitoring, sterile operative technique,psychotherapy,anti-platelet combining with two drugs, anticoagulation, percutaneous coronary interventions and mechanical ventilation can reduce the incidence of acute myocardial infarction patients complicated with MODS.

【Key　ｗｏｒｄｓ】acute myocardial infarction; multiple organs dysfunction syndrome; risk factors; logistic multivariate regression analysis