[Effect of demographic, anamnestic and clinical factors on hospital mortality in patients with myocardial infarct].

The objective of the work was to analyze local priority data on the possible effect of demographic, anamnestic and clinical factors in a non-selected population of 3123 patients with acute myocardial infarction (AIM) on the hospital mortality (HM). 12.6% patients with AIM died in hospital. The mean age of those who died was 71.92 years. There were more than 4 times more patients above 64 years than 64-year-old ones or younger ones who died. The mortality rate of 64-year-old patients and younger ones (5.2% is significantly lower than in patients above 64 years (19%). The mortality rate of patients above 74 years was 27.1%. Important correlations of the HM were moreover found--in women, patients living permanently in rural areas, in widowed subjects, in patients with elementary education, old age, pensioners and non-smokers. The HM was lower (< 10%) in patients with a history of complex ventricular arrhythmias, impaired lipid metabolism and those who had no other serious disease in the case-history. A higher HM (> 15%) was recorded in patients with a history of a cerebrovascular attack, with data on heart failure and in diabetic patients. The majority of patients (39.4% of all who died) died within 24 hours after admission. During the first three days 57% patients died. Analysis of the characteristic of AIM and HM revealed some clinically important data on the HM less than 30% (patients with complicated AIM, with elevated ST segments, with a left ventricular ejection fraction of less than 40% and with and concurrent heart failure). An adverse course of the disease with a high HM (> 30%) was found in patients with complications of AIM. It was highest, more than 60%, in patients after implemented cardiopulmonary resuscitation, in patients with a combination of three markers of imminent shock and patients in shock. The local priority findings on the HM assembled in Slovakia in a non-selected population of patients with AIM confirm that the high HM still persists in patients of advanced age and in women. It is adversely influenced also by some demographic data, educational level, some anamnestic and clinical factors. The HM of patients with AIM may be adversely influenced also by side-effects of protracted economic transformation which is under way. Data assembled in Slovakia are comparable with similar results assembled in other countries.