The factor associated with mortality rate in STEMI patients at King Narai Hospital, Lopburi province
Keywords:
ST elevation MI patients, Reperfusion after StreptokinaseAbstract
Objective : To study the factor associated with mortality rate in STEMI patients after Advanced Fast Track treatment
Method : This study was Cross- sectional study in 278 patients were diagnosed and treated with ST elevation Myocardial infarction in Kingnarai hospital between October 2013 to September 2015 The study was assessed in frequency percent mean variation in the first part. And the Logistic regression analysis Binary regression analysis was analysed the corelation and displayed the relation with odd ratio significant result with p< 0.05.
Result : The study samples 278 patients were mostly male (68.7%) with an average 64.45±13.26 years. 66.19 percent of the patients were STEMI with Anterior Wall, 28.06 percent were Inferior Wall and 5.75 percent were Lateral Wall and others. Eighty-five percent of the patients whom got the beginning diagnosed have the Killip severity with Class I,II, III and IV 56.83%, 3.96%, 16.91% and 22.30% respectively.There were 48.6% receive Streptokinase and the other consist of Contraindicate 16.19%, not consent 3.6% and not achieve golden period 31.65% .The vascular reperfusion after Streptokinase drip 54.81%, and mortality rate 19.42%. When consider the factor that relation with the mortality significantly were receive aspirin , receive clopidogrel , receive Low molecular weight Heparin (Enoxaparin), receive Statin and smoking display the correlation with odd ratio 0.053 (95%CI :0.019-0.145), 0.048 (95%CI:0.200-0.497), 0.091 (95%CI:0.160-0.951), 0.156 (95% CI: 0.133-0.559) และ 0.226 (95%CI: 0.067-0.756) respectively and significant (p < 0.05)
Conclusion : The factor associated with mortality rate we improve the system by to develope the Streptokinase system at Emergency room, In addition the result able to revise Clinical Practice Guideline by use aspirin, clopidogrel, low molecular weight Heparin (Enoxaparin), statin, beta blocker and ACEI by dose Recommendation and smoking sessation for prophylaxis and mortality rate reduction in STEMI patients.
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