Acute Myocardial Infarction in Surin Hospital
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Abstract
Background: Acute myocardial infarction is major cause of death in Surin hospital. However there is no research about management problems. Therefore this research was designed to study the clinical presentation of acute myocardial infarction patient admitted in Surin hospital during period of one year for develop the effective management protocol.
Objective: To determine the risks, clinical manifestation and management practice of acute myocardial infarction in Surin hospital.
Patients and Methods: All patients diagnosed with acute myocardial infarction in Surin hospital
Results: during 1st October 2004 to 30th September 2005. Data were collected and analyzed retrospectively. : There were 96 patients (40 men and 56 women) age ranged from 36 to 82 years (average age 61.41 years) admitted during the period of study. There was no significant difference of incidence between both sex. Clinical presentation is not specific consequently unclear diagnosis. Major co-morbid disease were diabetes 18(18.75%), hypertension 24(25%) and dyslipidemia 8(8.33%). Complication which led to death was cardiogenic shock. The frequently - used medications were ASA. Anti-anginal pain and inotropic drugs respectively. The usage of low specific and sensitive diagnostic tests was still found. The site of anterior infarction, inferior infarction, lateral wall infarction and RV infarction were 52(54.16%), 18(18.75%), 7(7.29%) and 4(4.17%) respectively. Utilization of Streptokinase still under the recommended guideline. Mean of hospitalization times was 3.08 days while the longest stay was one month. During hospitalization; first 24-hours mortality rate was high as 33.33%. Overall survival rate was low and rate of ICU admission was only 35.41%.
Conclusion: According to unclear first diagnosis (especially time to onset). Education in high risk groups to realize about reducing risk factors, create the AMI protocol for standard treatment, minimize process of treatment and organize referral system before the patient had developed serious complication. These will optimize best treatment for patient to reduce mortality and morbidity.
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References
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