scholarly journals MON-643 Diabetes’ Cost to Us Taxpayers: Thirty-Day Readmission and Resource Utilization Among Diabetics Patients Admitted with ST-Elevation Myocardial Infarction: A Propensity Score Match Analysis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Shabnam Nasserifar ◽  
Kam Sing Ho
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Hospital Cost ◽  
Primary Diagnosis ◽  
Total Hospital Cost ◽  
Secondary Diagnosis ◽  
Total Hospital ◽  
History Of ◽  
St Elevation

Abstract PURPOSE: To determine the relationship between diabetes and thirty-days readmission, mortality, morbidity, and health care resource utilization in patients who were admitted with ST-Elevation Myocardial Infarction (STEMI) in the United States. METHOD: A retrospective study was conducted using the AHRQ-HCUP Nationwide Readmission Database for the year 2014. Adults (≥ 18 years) with a primary diagnosis of STEMI (1), along with a secondary diagnosis of diabetes were identified using ICD-9 codes as described in the literature (2). The primary outcome was the rate of all-cause readmission within 30 days of discharge. Secondary outcomes were reasons for readmission, readmission mortality rate, morbidity, and resource use (length of stay and total hospitalization costs and charges). Propensity score (PS) using the 1:1 nearest neighbor matching without replacement was utilized to adjust for confounders (3). Independent risk factors for readmission were identified using a Cox proportional hazards model (4). RESULTS: In total, 116,124 hospital admissions among adults with a primary diagnosis of STEMI were identified, of which 18.05% were diabetics. 1:1 PS matching was performed based on demographic (age, gender, hospital status, etc.) and clinical characteristics (Charlson comorbidity score. The 30-day rate of readmission among diabetics and non-diabetics with STEMI were 9.31% vs. 6.18% (p <0.001). The most common readmission for both groups was recurrent myocardial infarction. During the index admission for STEMI, the length of stay (LOS) among diabetics and non-diabetics patients were not statistically different (4.74 vs 4.58 days, p=0.12). However, the total hospital cost for the diabetic patients was statistically different ($27,027 vs $24,807, p <0.001). Most importantly, diabetics patients’ in-hospital mortality rate during their index admission was significant higher (10.20% vs 5.92%, p <0.001). Amongst those readmitted, the LOS, total hospital cost, or in-hospital mortality among diabetics were not statistically different when compared to their counterparts during their readmission. Diabetes (HR 1.60, CI 1.27-2.02, p <0.001) was an independent predictor associated with higher risks of readmission. Other independent predictors associated with increased 30-day readmission include acute exacerbation of CHF, acute exacerbation of COPD, acute kidney injury, secondary diagnosis of pneumonia, history of COPD, history of ischemic stroke, history of atrial fibrillation & atrial flutter, history of chronic kidney disease, history of iron deficiency, and use of mechanical ventilator. CONCLUSION: In this study, diabetics patients admitted with STEMI have a higher 30 days of readmission rate, total hospital cost, and in-hospital mortality (p <0.001) than their non-diabetic counterparts.

Abstract 473: Will Obesity Bankrupt the United States? Obese Patients Who Underwent Cardiopulmonary Resuscitation Have Increased Thirty-Day Readmission and Total Hospital Cost

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Kam Ho ◽  
Bharat Narasimhan ◽  
Lingling Wu ◽  
Shabnam Nasserifar ◽  
Jacqueline Sheehan ◽  
...  
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Cardiopulmonary Resuscitation ◽  
Hospital Mortality ◽  
The United States ◽  
Total Hospital Cost ◽  
Obese Patients ◽  
Secondary Diagnosis ◽  
Total Hospital ◽  
Total Cost

Purpose: To determine the relationship between obesity and thirty-days readmission, mortality, morbidity, and health care resource utilization in patients who underwent cardiopulmonary resuscitation (CPR) during their hospitalization in the in the United States. Method: A retrospective study was conducted using the AHRQ-HCUP NRD for the year 2014. Adults (≥ 18 years) with a primary diagnosis of CPR (1), along with a secondary diagnosis of obesity were identified using ICD-9 codes as described in the literature (2). The primary outcome was the rate of all-cause readmission within 30 days of discharge. Secondary outcomes were reasons for readmission, readmission mortality rate, morbidity, and resource use. Propensity score (PS) using the 1:1 nearest neighbor matching without replacement was utilized to adjust for confounders (3). Results: 113,394 hospital admissions among adults with a primary and secondary diagnosis of CPR were identified, of which 14.8% were obese. 1:1 PS matching was performed based on demographic and clinical characteristics. The 30-day rate of readmission among obese and non-obese with CPR were 4.94% and 2.82% (p <0.001). The most common readmission for both groups was unspecified sepsis (17.3%). During the index admission for CPR, the length of stay (LOS) among obese and non-obese patients were similar (10.3 vs 9.4 days, p=0.16). However, the total cost for the obese patients was statistically different ($33,232 vs $33,692, p <0.001). Most importantly, obese patients’ in-hospital mortality rate during their index admission was significant higher (58.7% vs 6.72%, p <0.001). Amongst those readmitted, obese patients similarly had a significantly longer LOS than their non-obese counterparts (8.1 vs 4.5 days, p <0.001) and their total cost was more expensive ($19,027 vs $10,572, p <0.001). But, obese patients’ in-hospital mortality rate during their readmission was not significant different (0.34 % vs 0.08%, p =0.09). Obesity (HR 1.77, p <0.02) was an independent predictor associated with higher risks of readmission. Conclusion: In this study, obese patients admitted with CPR have a higher 30 days of readmission rate, total hospital cost, and in-hospital mortality (p <0.02) than non-obese patients.

scholarly journals In-Hospital Outcomes of Acute ST Elevation Myocardial Infarction in Patients with Acute Kidney Injury

2018 ◽  
Vol 11 (1) ◽  
pp. 59-66
Author(s):  
Md Mosharul Haque ◽  
M Atahar Ali ◽  
Mustafizul Aziz ◽  
Mohammad Ullah ◽  
Mohammad Anowar Hossain ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Mortality Rate ◽  
Serum Creatinine ◽  
Hospital Mortality ◽  
Independent Predictor ◽  
Kidney Injury ◽  
Group I ◽  
St Elevation ◽  
Group Ii

Background: Acute kidney injury (AKI) is a risk factor for long-term adverse outcomes, including acute myocardial infarction and death. The objective of this study was to find out in-hospital outcomes in patients with acute ST elevation myocardial infarction with acute kidney injury.Methods: A total 190 patients were included in this study and were equally divided into two groups, Group-I (with AKI) and Group-II (without AKI), according to absolute changes of serum creatinine level. AKI was defined as absolute changes in serum creatinine (SCr. at 48 hours’ minus admission SCr) and categorized as mild AKI (increase of 0.3 to <0.5 mg/d), moderate AKI (increase of 0.5 to <1.0 mg/dl), and severe AKI (increase of e”1.0 mg/dl) using Acute Kidney Injury Network (AKIN) criteria.Results: Overall in-hospital mortality rate was 14.7% in Group-I (mortality rate for those with mild, moderate, and severe AKI were 7%, 13.3%, and 31.8%) compared with 5.3% in Group-II. Regarding inhospital morbidities, significant arrhythmia (29.5%) was the most common complication followed by acute heart failure (18.9%), cardiogenic shock (12.6%), and mechanical complications (4.2%) which were more in Group-I compared to patients with Group-II. After adjustment of other risk variables, the multivariate logistic regression analysis revealed AKI remained an independent predictor of in-hospital mortality with adjusted odds ratios (OR) was 4.991 (95% confidence interval, 1.873-13.301).Conclusions: AKI is an independent predictor of in-hospital mortality and morbidity. It emphasizes the importance of efforts to identify risk factors and to prevent AKI during in-hospital management of acute STEMI patients.Cardiovasc. j. 2018; 11(1): 59-66

Abstract 368: Association of Atrial Fibrillation with In-hospital Outcomes in ST-Elevation Myocardial Infarction - A Propensity Matched Study

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Prakash Harikrishnan ◽  
Marjan Mujib ◽  
Tanush Gupta ◽  
Dhaval Kolte ◽  
Chandrasekar Palaniswamy ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Average Length ◽  
St Elevation Myocardial Infarction ◽  
Hospital Charges ◽  
Total Hospital ◽  
Average Length Of Stay ◽  
St Elevation

Background: Atrial fibrillation is a relatively common comorbid condition in patients with coronary artery disease. However, there are limited data on the association of atrial fibrillation (AF) with outcomes in ST-elevation myocardial infarction (STEMI). Methods: We queried the 2003-2011 Nationwide Inpatient Sample databases using the ICD-9 diagnosis codes, to identify all patients > 18 years admitted with a primary diagnosis of STEMI. We studied the association of AF with in-hospital outcomes in these patients both by regression analysis and propensity match to adjust for demographics, hospital characteristics and co-morbidities. Results: Of the total 452,772 (64.5% men) STEMI hospitalizations, AF was documented in 58,273 (12.9%) cases. Patients with AF were older (mean age 75±12 vs 64±14 years; p<0.001) and had a higher proportion of women (42.5% vs 34.5%; p<0.001) than patients without AF. STEMI patients with AF had a higher risk-adjusted in-hospital mortality (OR 1.15, 95% CI 1.12-1.19, p<0.001), longer average length of stay (7 days vs 4 days, P<0.001) and higher average total hospital charges ($74,082 vs $57,331, P<0.001) than those without AF. Using propensity matching, 57,388 STEMI patients with AF were compared with the same number of patients without AF. Within these matched cohorts, STEMI patients with AF had higher in-hospital mortality (16.7% vs 15.1%, OR 1.13, 95% CI 1.09-1.16; p<0.001), longer average length of stay (7 days vs 6 days, P<0.001), and higher average total hospital charges ($73,832 vs $65,201, P<0.001) than patients without AF. Conclusions: In patients hospitalized with STEMI, AF was independently associated with modestly higher in-hospital mortality, higher hospital charges, and longer length of stay.

Does acute myocardial infarction kill more people on weekends? Analysis of in-hospital mortality rates for weekend admissions in Portugal

2018 ◽  
Vol 23 (2) ◽  
pp. 87-97 ◽  
Author(s):  
Francesca Fiorentino ◽  
Raquel Ascenção ◽  
Nicoletta Rosati
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Care Delivery ◽  
Severity Index ◽  
Mortality Rates ◽  
Primary Diagnosis ◽  
Weekend Effect ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

Objectives To investigate a possible weekend effect in the in-hospital mortality rate for acute myocardial infarction in Portugal, and whether the delay in invasive intervention contributes to this effect. Methods Data from the National 2011–2015 Diagnostic-Related-Group databases were analysed. The focus was on adult patients admitted via the emergency department and with the primary diagnosis of acute myocardial infarction. Patients were grouped according to ST-elevation myocardial infarction and non-ST-elevation myocardial infarction episodes. We employed multivariable logistic regressions to determine the association between weekend admission and in-hospital mortality, controlling for episode complexity (through a severity index and acute comorbidities), demographic characteristics and hospital identifications. The association between the probability of a prompt surgery (within one day) and the day of admission was investigated to explore the possible delay of care delivery for patients admitted during weekends. Results Our results indicate that in-hospital mortality rates were not significantly higher for weekend admissions than for weekday admissions in both ST-elevation myocardial infarction (STEMI) and non-STEMI episodes. This result is robust to the inclusion of a number of potential confounding mechanisms. Patients admitted on weekends had lower probabilities of undergoing invasive cardiac surgery within the day after admission, but delay in care delivery during the weekend was not associated with worse outcomes in terms of in-hospital mortality. Conclusions There is no evidence for the existence of a weekend effect due to admission for acute myocardial infarction in Portugal, in both STEMI and non-STEMI episodes.

scholarly journals Hospital mortality trend analysis of patients with ST elevation myocardial infarction in the Belgrade area coronary care units

2008 ◽  
Vol 136 (Suppl. 2) ◽  
pp. 84-96 ◽  
Author(s):  
Zorana Vasiljevic ◽  
Bojan Stojanovic ◽  
Nikola Kocev ◽  
Branislav Stefanovic ◽  
Igor Mrdovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Reperfusion Therapy ◽  
St Elevation ◽  
Coronary Care ◽  
Coronary Care Units

INTRODUCTION. Mortality in ST elevation myocardial infarction (STEMI) ranges from 4-24% and is dependent on the variety of patients? clinical characteristics (CC) that are present prior to and within the first hours of the onset of MI, affecting reliability of the diagnosis. The higher mortality rate of patients with STEMI should be associated with a higher rate of applied reperfusion therapy according to guidelines and randomized study results, which is in opposition to everyday hospital practice. OBJECTIVE. The aim of this study was to analyze the mortality of STEMI patients in relationship to their clinical characteristics at presentation, their age, sex, risk factors, prior coronary disease, and time interval from symptom onset to hospital presentation, complications and administered therapy. METHOD. The analysis involved patients treated in five coronary care units, four Belgrade Hospital Centres and the Belgrade Emergency Centre of the Clinical Centre of Serbia. Evaluated data was obtained from the Serbian National Registry for Acute Coronary Syndrome (REAKSS) and databases of local coronary care units (CCU). RESULTS. During 2005 and 2006, a total of 2739 patients with STEMI, of average age 63.3?11.7, with 64.9% males aged 61.3?11.7 and 35.1% females aged 67.0?10.7 (p<0.01) who underwent treatment. Most of the patients (80.5%) were distributed within the elderly groups of 60, 70 and 80 years of age, with the highest percent of mortality rate (45.9%) noted at age 80 years. Anterior localization of myocardial infarction was observed in 40.2% of patients, with lethal outcome in 21.4% patients, while 59.8% of patients suffered inferiorly localized MI with much lower mortality rate (12.2%, p<0.01). In 2005, STEMI was registered in 48.7%, while in 2006 in 44.7% of patients. Prior angina pectoris was present in 19.9% of patients, more frequently among women (p<0.05), prior MI in 14.5% of patients, more often among males (p<0.05), while aortocoronary revascularization was found in 3.9% of patients. Hospital mortality rate due to STEMI was higher in the group of patients with a history of prior MI (19.1% vs. 15.7%; p>0.05). Regarding risk factors, hypertension was present in 61.8% of patients, more often among women (69.1% vs.57.9%) (p<0.01), carrying a higher mortality rate of 18.9% vs. 9.9% among males (p<0.01). Hyperlipidemia was found in 31.9% of patients; more frequently among women 34.8% vs. 30.4% males (p<0.05), as well as diabetes mellitus observed in 25.1% of patients; 22.4 % males and 30.1% females (p<0.01). 39.6% of patients were smokers; 46.9% males and 28.0% females (p<0.01). Heart failure had 33.4% of patients; mortality rate was registered in 28.2% of patients, and was significantly higher than in the non heart failure group (7.9%, p<0.01). Heart rhythm disorders were registered in 21.3% of patients, more frequently involving posterior MI 55.3% vs 44.7% of anterior MI (p>0.05), and was significantly higher among females 23.5% vs. 20.1% in males (p<0.05). In 2005 in Belgrade hospitals, reperfusion therapy (RT) was performed in 34.6% of patients, mostly as thrombolytic therapy (TT) (in 99.0% of patients), and as percutaneous coronary intervention (PCI) in 1.0% of patients. STEMI mortality rate was 12.8%. In 2006, in the CCU of the In the Emergency Center RT was applied in 48.0% of patients, TT in 13.8% and PCI in 34.2%, while classical therapy without RT was applied in 52.0% of patients. CONCLUSION. Clinical characteristics significantly influence mortality in STEMI; a significantly higher mortality is among women, patients in their 80?s and 90?s, anterior MI localization and prior coronary disease. RT significantly lowers mortality in STEMI compared to the use of classical therapeutic approach and therefore STEMI patients with a higher mortality determined by their prehospital charactheristics, i.e. higher risk, are those who have higher benefit of RT, which should be taken into consideration when making decision about the therapy of choice.

scholarly journals INA-CBGs claim versus total hospital cost: A vaginal delivery investigation at Airlangga University Academic Hospital, Indonesia

2020 ◽  
Vol 9 (4) ◽  
Author(s):  
Manggala Pasca Wardhana ◽  
Khanisyah Erza Gumilar ◽  
Prima Rahmadhany ◽  
Erni Rosita Dewi ◽  
Muhammad Ardian Cahya Laksana
Keyword(s):  
Vaginal Delivery ◽  
Hospital Cost ◽  
Hospital Costs ◽  
Cross Sectional Study ◽  
Primary Diagnosis ◽  
Total Hospital Cost ◽  
Academic Hospital ◽  
Total Hospital ◽  
Cross Sectional ◽  
Level Ii

Background: Inadequate funding for vaginal delivery can be one of the barriers to reducing the maternal mortality rate. It could be therefore critical to compare the vaginal delivery cost between total hospital cost and INA-CBGs cost in national health insurance. Methods: This was a retrospective cross-sectional study conducted from October to December 2019 in Universitas Airlangga Academic Hospital. It collected data on primary diagnosis, length of stay, total hospital cost, INA-CBGs cost, and counted disparity. The data analyzed statistically using t-test independent sample (or Mann-Whitney test).Results: A total of 149 vaginal delivery claims were found, with the majority having a level II severity (79.87%) and moderate preeclampsia as a primary diagnosis (20.1%). There was a significant disparity in higher total hospital costs compared with government INA-CBGs costs (Rp. 9,238,022.09±1,265,801.88 vs 1,881,521.48±12,830.15; p<0.001). There was also an increase of LOS (p<0.001), total hospital cost (p<0.001), and cost disparity (p<0.01) in a higher severity level of vaginal delivery.Conclusion: Vaginal delivery costs in INA-CBGs scheme are underneath the actuarial value. There was also an increase in total hospital costs and a more significant disparity in the higher severity levels of vaginal delivery.

scholarly journals In-hospital mortality among consecutive patients with ST-Elevation myocardial infarction in modern primary percutaneous intervention era ~ Insights from 15-year data of single-center hospital-based registry ~

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252503
Author(s):  
Kensuke Takagi ◽  
Akihito Tanaka ◽  
Naoki Yoshioka ◽  
Yasuhiro Morita ◽  
Ruka Yoshida ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
St Elevation Myocardial Infarction ◽  
Single Center ◽  
Killip Class ◽  
Center Hospital ◽  
St Elevation ◽  
Angiographic Findings

Objective To clarify the association of detailed angiographic findings with in-hospital outcome after primary percutaneous coronary intervention (p-PCI) for ST-elevation myocardial infarction (STEMI) in Japan. Background Data regarding the association of detailed angiographic findings with in-hospital outcome after STEMI are limited in the p-PCI era. Methods Between January-2004 and December-2018, 1735 patients with STEMI (mean age, 68.5 years; female, 24.6%) who presented to the hospital in the 24-hours after symptom onset and underwent p-PCI were evaluated using the disease registries. The registry is an ongoing, retrospective, single-center hospital-based registry. Results The 30-day mortality rate and in-hospital mortality rate were 7.7% and 9.2%, respectively. Independent predictors of in-hospital mortality were ejection fraction (EF) < 40% [adjusted Odds Ratio (aOR), 4.446, p < 0.001], culprit lesions in the left coronary artery (LCA) (aOR, 2.940, p < 0.001) compared with those in the right coronary artery, Killip class > II (aOR, 7.438; p < 0.001), chronic kidney disease (CKD) (aOR, 4.056; p < 0.001), final thrombolysis in myocardial infarction (TIMI) grades 0/1/2 (aOR, 1.809; p = 0.03), absence of robust collaterals (aOR, 17.309; p = 0.01) and hypertension (aOR, 0.449; p = 0.01). Conclusions Among the consecutive patients with STEMI, the in-hospital mortality rate after p-PCI significantly improved in the second half. Not only CKD, Killip class > II, and EF < 40%, but also the angiographic findings such as culprit lesions in the LCA, absence of very robust collaterals, and final TIMI grades <3 were associated with an increased risk of in-hospital mortality.

Abstract 16860: Racial Disparity in COVID-19 Patients With Concomitant Myocardial Injury

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Brian C Case ◽  
Charan Yerasi ◽  
Brian Forrestal ◽  
Chava Chezar Azerrad ◽  
Lowell F Satler ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
African Americans ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Racial Disparity ◽  
Inflammatory Markers ◽  
Myocardial Injury ◽  
International Classification Of Diseases ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

Introduction: Cardiac involvement in Coronavirus Disease 2019 (COVID-19) is common. Estimated that 30% of patients hospitalized with COVID-19 have an elevated troponin and these patients have worse prognosis when compared to patients without myocardial injury. Hypothesis: The purpose of this study is to investigate if there is any racial disparity in the in-hospital clinical outcomes of COVID-19 patients with myocardial injury. Methods: This study included all COVID-19 positive patients within the MedStar Health System (11 acute hospitals in the DC/Maryland/Virginia area) with an elevation of troponin and a diagnosis of either ST-Elevation Myocardial Infarction (STEMI) or Non-ST-Elevation Myocardial Infarction (NSTEMI) based on International Classification of Diseases-10. Results: There was 3,589 COVID-19 admissions between March to June 2020. Of these, a total of 75 COVID-19 patients had either a STEMI or NSTEMI. Overall mean age was 70.9 ± 14.6 and 54.7% were male. Of these patients, the majority were African American (51; 68%) followed by Caucasians (15; 20%). The overall in-hospital mortality rate was 24.3%, with African Americans having a higher rate (73.7%) as compared to Caucasians (15.8%) p 0.05. Furthermore, African Americans trended toward having higher rates of intensive care unit (ICU) admissions, intubation, and longer ICU stays; however, not statistically significant. Despite African Americans appearing to be a sicker cohort, inflammatory markers and myocardial involvement did not differ between the two groups (Table 1). Conclusions: Patients with COVID-19 and concomitant myocardial injury have a high in-hospital mortality rate. There is a racial disparity with African Americans having a higher rate of in-hospital mortality. However, inflammatory markers and myocardial injury does not differ between the two groups meaning other unidentified underlying issue may be the etiology for a sicker cohort in African Americans.

scholarly journals MYOCARDIAL INFARCTION

2011 ◽  
Vol 18 (03) ◽  
pp. 418-425
Author(s):  
LIAQAT ALI ◽  
ABDUL REHMAN ABID ◽  
JAHANGIR AHMED ◽  
Nusrat Niaz ◽  
Tahira Abdul Rehman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Family History ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Anterior Wall ◽  
History Of ◽  
Streptokinase Therapy ◽  
St Elevation ◽  
Anterior Wall Myocardial Infarction

Objective: To determine clinical predictors of in-hospital complications in patients presenting with acute ST elevation myocardial infarction. Design: Descriptive Study. Period: from October 2010 to January 2011. Setting: Faisalabad Institute of Cardiology, Faisalabad.. Materials and methods: A total 342 patients with AMI were recruited in this study. All patients presenting with acute ST elevation myocardial infarction and fulfilling inclusion and exclusion criteria were included in the study. A full history was taken, particularly age, sex, occupation, address, history of smoking, diabetes mellitus, hypertension, ischemic heart disease and family history of ischemic heart disease. Primary end point was death while secondary end point were patients who had mechanical, ischemic or electrical complications or all of them. Results: Mean age of the study population was 56.3±12.7 years. There were 255(74.6%) males and 87(25.4%) females. There were 103(30.1%) diabetics, 137(40.1%) hypertensive and 174(50.9%) smokers. Family history of IHD was present in 34(9.9%). Obesity was observed in 60(17.5%). Dyslipidemia was observed in 45(13.2%). Majority of patients 123(36%) presented between 4-8 hours after the onset of symptoms. Only 72(21.1%) patients presented to the hospital within 4 hours of onset of symptoms. Overall 194(56.7%) patients had anterior wall myocardial infarction followed by Inferior wall myocardial infarction 84(24.6%) patients. Streptokinase therapy for thrombolysis was given to 236(69%) patients. Overall in-hospital mortality was 28(8.2%). Most frequent in-hospital complication was cardiogenic shock occurring in 38(11.1%) followed by Ischemic complications (Post MI angina and Re-MI) 37(10.8%), heart failure in 37(10.8%) and 1st and 2nd degree AV blocks in 36(10.5%) patients. In-hospital mortality was most significantly associated with site of MI i.e. anterior wall myocardial infarction (X2=28.88, p=0.0001) followed by patients not receiving Streptokinase therapy (X2=18, p=0.001), Age (X2=10.13, p=0.006). Site of MI had the highest Contingency Coefficient value of 0.279 followed by Streptokinase therapy 0.195 and age 0.170. Conclusions: Cardiogenic shock was the most frequent complication. Major predictors of in-hospital mortality were anterior wall myocardial infarction, patients not receiving streptokinase therapy and old age.

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