Predictors of mortality at one - year after hospital discharge among patients with acute coronary syndrome
Keywords:
Acute coronary syndrome, GRACE risk score, mortalityAbstract
This retrospective cohort study aimed to examine the predictors for one-year mortality after hospital discharge among patient with ACS. Eligible samples were a total of 187 ACS patients. Reviews of annual medical records were conducted for data collection. Global Registry of Acute Coronary Events (GRACE) risk score was used to assess and stratify risk level for mortality prediction. Descriptive and Cox proportional hazard model statistics were used to analyze descriptive data and predictors for one-year mortality after hospital discharge, respectively.
Results showed that most of the patients in this study were male (68.45 %), an average age of 66.22 ± 15.80 years. The prevalence rate of mortality was 14.97 % at one-year after hospital discharge. High level of GRACE risk score predicts mortality HR= 6.98 (95%CI: 1.58-30.79; p= 0.010). Multi-factors analysis with mortality, presented that high cardiac enzyme level, previous heart failure history, cardiac arrest, and high risk level of GRACE risk score, were significant to predict mortality that were adjusted HR 9.13 (95%CI: 1.18-70.75; p= 0.034), adjusted HR 2.74 (95%CI: 1.03-7.32; p= 0.043), adjust HR= 4.37 (95%CI: 1.57-12.17; p= 0.005), and adjusted HR= 2.59 (95%CI: 1.08-6.22; p= 0.033, respectively).
The findings of this study are deeply concerned that the GRACE risk score should be applied to stratify the risk level of mortality in patient with ACS. Patient with ACS who have high risk level of GRACE risk score, high cardiac enzyme level, previous heart failure history, and cardiac arrest should receive specific and continuing care after hospital discharge for preventing mortality.
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