scholarly journals Hipoalbuminemia pada Pasien Usia Lanjut dengan Pneumonia Komunitas: Prevalensi dan Pengaruhnya Terhadap Kesintasan

2017 ◽  
Vol 1 (2) ◽  
pp. 79
Author(s):  
Wawan Kurniawan ◽  
C Martin Rumende ◽  
Kuntjoro Harimurti
Keyword(s):  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Rank Test ◽  
Proportional Hazard ◽  
Hazard Regression ◽  
Log Rank Test ◽  
Kaplan Meier

Pendahuluan. Hipoalbuminemia merupakan salah satu penanda risiko mortalitas, tetapi belum banyak yang mempertimbangkan faktor waktu (seberapa cepat terjadinya mortalitas). Penelitian ini mengevaluasi pengaruh hipoalbuminemia terhadap kecepatan terjadinya mortalitas pada pasien usia lanjut dengan pneumonia komunitas. Penelitian ini bertujuan untuk mengetahui prevalensi hipoalbuminemia dan pengaruhnya terhadap kesintasan pasien usia lanjut yang dirawat dengan pneumonia komunitas.Metode. Penelitian dengan disain kohort retrospektif dilakukan terhadap 142 pasien usia lanjut dengan pneumonia komunitas yang dirawat di RSCM pada kurun waktu Januari-Oktober 2010. Data klinis dan laboratoris diambil dalam 24 jam pertama kedatangan (data sekunder) dan kemudian diikuti dalam 30 hari untuk melihat status mortalitasnya. Perbedaan kesintasan hipoalbuminemia ditampilkan dalam kurva Kaplan Meier dan perbedaan kesintasan diantara dua atau lebih kelompok akan diuji dengan Log-rank test, dengan batas kemaknaan <0.05, serta analisis multivariat dengan Cox’s proportional hazard regression untuk menghitung adjusted hazard ratio (dan interval kepercayaan 95%-nya) antara pasien usila dengan pneumonia yang mengalami hipoalbuminemia terhadap yang normoalbuminemia dengan koreksi terhadap variabel-variabel perancu.Hasil. Prevalensi hipoalbuminemia pada pasien usila dengan pneumonia komunitas sebesar 71,1% (IK95% 0,64-0,78). Rerata kesintasan pada kelompok dengan kadar albumin normal adalah 27 hari (IK95% 24,35-30,98), sedangkan pada kelompok albumin 2,5-3,4 g/dL rerata kesintasannya adalah 22 hari (IK95% 19,66-25,13) dan pada kelompok albumin kurang dari 2,5 g/dL rerata kesintasannya adalah 19 hari (IK95% 13,07-26,23). Crude hazard ratio (HR) pasien dengan kadar albumin antara 2,5-3,4 g/dL adalah 4,49 (IK95% 1,05-19,20) dan pada pasien dengan kadar albumin kurang dari 2,5 g/dL adalah 7,26 (IK95% 1,46-36,09) bila dibandingkan dengan pasien dengan kadar albumin normal (≥3,5 g/dL). Setelah penambahan variabel perancu, didapatkan fully adjusted hazard ratio sebesar 3,81 (IK95% 0,86-16,95) untuk kelompok albumin antara 2,5-3,4 g/dL dan 11,09 (IK95% 1,79-68,65) untuk kelompok albumin kurang dari 2,5 g/dL.Simpulan. Prevalensi hipoalbuminemia pada usia lanjut dengan pneumonia komunitas adalah 71,1%. Terdapat perbedaan kesintasan 30 hari pasien pneumonia usia lanjut yang mengalami hipoalbuminemia dibanding dengan yang normoalbuminemia (≥3,5 g/dL). Kesintasan pada pasien dengan keadaan hipoalbuminemia yang berat lebih buruk dibandingkan pada keadaan hipoalbuminemia ringan.

Dementia and the Risk of Periodontitis: A Population-Based Cohort Study

2021 ◽  
pp. 002203452110372
Author(s):  
K.S. Ma ◽  
H. Hasturk ◽  
I. Carreras ◽  
A. Dedeoglu ◽  
J.J. Veeravalli ◽  
...  
Keyword(s):  
Cohort Study ◽  
Relative Risk ◽  
Propensity Score ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Rank Test ◽  
Confounding Factors ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Log Rank Test

Dementia and Alzheimer’s disease (AD) are proposed to be comorbid with periodontitis (PD). It is unclear whether PD is associated with dementia and AD independent of confounding factors. We aimed at identifying the relationship between the longitudinal risk of developing PD in a cohort of patients with dementia and AD who did not show any signs of PD at baseline. In this retrospective cohort study, 8,640 patients with dementia without prior PD were recruited, and 8,640 individuals without dementia history were selected as propensity score–matched controls. A Cox proportional hazard model was developed to estimate the risk of developing PD over 10 y. Cumulative probability was derived to assess the time-dependent effect of dementia on PD. Of the 8,640 patients, a sensitivity test was conducted on 606 patients with AD-associated dementia and 606 non-AD propensity score–matched controls to identify the impact of AD-associated dementia on the risk for PD. Subgroup analyses on age stratification were included. Overall 2,670 patients with dementia developed PD. The relative risk of PD in these patients was significantly higher than in the nondementia group (1.825, 95% CI = 1.715 to 1.942). Cox proportional hazard models showed that patients with dementia were more likely to have PD than individuals without dementia (adjusted hazard ratio = 1.915, 95% CI = 1.766 to 2.077, P < 0.0001, log-rank test P < 0.0001). The risk of PD in patients with dementia was age dependent ( P values for all ages <0.0001); younger patients with dementia were more likely to develop PD. The findings persisted for patients with AD: the relative risk (1.531, 95% CI = 1.209 to 1.939) and adjusted hazard ratio (1.667, 95% CI = 1.244 to 2.232; log-rank test P = 0.0004) of PD in patients with AD were significantly higher than the non-AD cohort. Our findings demonstrated that dementia and AD were associated with a higher risk of PD dependent of age and independent of systemic confounding factors.

Characteristics and outcomes of Embolic Stroke of Undetermined Source according to stroke severity

2020 ◽  
Vol 15 (8) ◽  
pp. 866-871
Author(s):  
Ioannis Leventis ◽  
Kalliopi Perlepe ◽  
Dimitrios Sagris ◽  
Gaia Sirimarco ◽  
Davide Strambo ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Rank Test ◽  
Stroke Recurrence ◽  
Cumulative Probability ◽  
Stroke Severity ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Product Limit

Background and aims Patients with embolic strokes of undetermined source (ESUS) usually present with mild symptoms. We aimed to compare the baseline characteristics between mild and severe ESUS, identify predictors for severe ESUS, and assess outcomes of patients with severe ESUS. Methods In the AF-ESUS (AF-ESUS) dataset, we stratified ESUS severity using the median National Institutes of Health Stroke Scale (NIHSS) score on admission as cut-off. We performed multivariable stepwise regression analyses to identify independent predictors of severe ESUS and to assess the association between ESUS severity and stroke recurrence, death, and new incident atrial fibrillation (AF) on follow-up. The 10-year cumulative probabilities of outcome incidence were estimated by the Kaplan–Meier product limit method. Results In 772 patients (median NIHSS: 6 (interquartile range: 3–12)), 414 (53.6%) patients had severe ESUS (i.e. NIHSS ≥6). Female sex was the only independent predictor for severe ESUS (odds ratio: 1.72 (1.27–2.33)). The rates of recurrence (3.3%/year vs. 3.4%/year, adjusted-hazard ratio: 1.09 (0.73–1.62)) and new incident AF (13.5% vs. 17.0%, adjusted odds ratio: 0.67 (0.44–1.03)) were similar between severe and mild ESUS, but mortality was higher (5.4%/year vs. 3.7%/year, adjusted-hazard ratio: 1.51 (1.05–2.16)) in severe ESUS. The 10-year cumulative probability for stroke recurrence was similar between severe and mild ESUS (38.1% (29.2–48.6) vs. 36.6% (27.8–47.0), log-rank test: 0.01, p = 0.920). The 10-year cumulative probability of death was higher in patients with severe ESUS compared with mild ESUS (40.5% (32.5–50.0) vs. 34.0% (26.0–43.6) respectively; log-rank test: 4.54, p = 0.033). Conclusions Women have more severe ESUS compared with men. Patients with severe ESUS have similar rates of stroke recurrence and new incident AF, but higher mortality compared with mild ESUS.

scholarly journals Peran Tindakan Revaskularisasi terhadap Kesintasan Pasien Non ST Elevation Myocardial Infarction (NSTEMI)

2017 ◽  
Vol 1 (1) ◽  
pp. 24
Author(s):  
Gerie Amarendra ◽  
Lukman H Makmun ◽  
Dono Antono ◽  
Esthika Dewiasty
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Rank Test ◽  
Proportional Hazard ◽  
Hazard Regression ◽  
Cox Proportional Hazard ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
St Elevation ◽  
Cox Proportional Hazard Regression

Pendahuluan. Pengaruh revaskularisasi terhadap kesintasan pasien non ST elevation myocardial infarction (NSTEMI) masih belum jelas. Waktu revaskularisasi yang optimal pada pasien NSTEMI belum ditemukan. Penelitian ini bertujuan mengetahui pengaruh revaskularisasi terhadap kesintasan pasien NSTEMI, juga mengetahui pengaruh waktu revaskularisasi terhadap kesintasan pasien NSTEMI.Metode. Penelitian dengan disain kohort retrospektif dilakukan terhadap 300 pasien non ST elevation myocardial infarction yang dirawat di RSUPNCM pada kurun waktu Desember 2006-Maret 2011. Data klinis, laboratorium, elektrokardiografi (EKG), ekokardiografi, dan angiografi koroner dikumpulkan. Pasien yang telah terhitung enam bulan setelah onset kemudian dihubungi melalui telepon untuk melihat status mortalitasnya. Perbedaan kesintasan revaskularisasi ditampilkan dalam kurva Kaplan Meier dan perbedaan kesintasan diantara dua kelompok diuji dengan Log-rank test dengan batas kemaknaan <0,05, serta analisis multivariat dengan Cox proportional hazard regression untuk menghitung adjusted hazard ratio (dan interval kepercayaan 95%) antara pasien NSTEMI yang menjalani terapi medikamentosa dan revaskularisasi terhadap kelompok medikamentosa dengan memasukkan variabel perancu.Hasil. Terdapat perbedaan kesintasan yang bermakna pada uji log rank (p<0,001) antara pasien NSTEMI yang menjalani revaskularisasi dan terapi medikamentosa saja dengan crude HR 0,19 (IK95% 0,11-0,34) dan fully adjusted HR 0,33 (IK95% 0,17-0,64). Faktor perancu yang bermakna adalah penurunan fungsi ginjal dan syok kardiogenik. Pada analisis kesintasan berdasarkan waktu revaskularisasi tidak didapatkan perbedaan kesintasan antara pasien yang menjalani revaskularisasi < 1 minggu, 1-2 minggu, 2-3 minggu, 3-4 minggu, 4-5 minggu dengan p=0,853.Simpulan. Kesintasan enam bulan pasien NSTEMI yang menjalani terapi medikamentosa dan revaskularisasi lebih baik dibandingkan dengan terapi medikamentosa saja. Tidak terdapat perbedaan kesintasan enam bulan pasien NSTEMI berdasarkan waktu revaskularisasi.

scholarly journals Metformin and Diabetes Prevention in Patients with Prediabetes: Results from Isfahan Diabetes Prevention Study (IDPS)

2021 ◽  
pp. 65-74
Author(s):  
Parisa Khodabandeh Shahraki ◽  
Awat Feizi ◽  
Ashraf Aminorroaya ◽  
Mahboubeh Farmani ◽  
Massoud Amini
Keyword(s):  
Diabetes Prevention ◽  
Rank Test ◽  
Proportional Hazard ◽  
Medical Sciences ◽  
Cox Proportional Hazard ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Adjusted Model

Aim: Although, the effectiveness of metformin in diabetes treatment is well established, its preventive effect in the development of diabetes is still unclear in real world. We aimed to determine the effectiveness of metformin therapy as a single preventive agent in patients with prediabetes in a cohort study (IDPS). Study Design: In this prospective observational study. Place and Duration of Study: Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Methodology: We included 410 patients with prediabetes (168 metformin user, 242 non-users), who participated in IDPS. To determine the association between metformin use and incidence of type 2 diabetes, Cox proportional hazard method, Kaplan-Meier and log Rank test were used. Results: In fully adjusted model for all confounders, significant hazard ratio (HR) for staying prediabetes rather than returning to normal was detected in male group of metformin non-user (HR: 2·41 [95% CI 1.01-5.79]; P<0·05) and those metformin non-user who had both Impaired Fasting Glucose and Impaired Glucose Tolerance (IFG & IGT) (HR: 2.13 [95% CI 1.05-4.34]; P=0·04).  There was no significant difference in terms of developing diabetes risk between metformin users and non-users. Conclusion: This study evidenced that males and patients with IFG & IGT who had not used metformin are at higher risk to staying prediabetes than returning to normal.

scholarly journals Pemodelan Regresi Cox Proportional Hazard Pada Data Perceraian

2020 ◽  
Vol 6 (2) ◽  
pp. 49-58
Author(s):  
Haykal Abidin ◽  
Novita Eka Chandra ◽  
Mohammad Syaiful Pradana
Keyword(s):  
Domestic Violence ◽  
Predictor Variable ◽  
Rank Test ◽  
Proportional Hazard ◽  
Forced Marriage ◽  
Hazard Regression ◽  
Model Parameter ◽  
Cox Proportional Hazard ◽  
Log Rank Test ◽  
Cox Proportional Hazard Regression

The purpose of this research is modeling the Cox proportional hazard regression form on divorce data in Pelaihari sub-district, Tanah Laut district, South Kalimantan province. The source of the data comes from the Court Decision in Pelaihari District, Tanah Laut Regency, South Kalimantan. The data analysis technique uses software R with the steps, namely data description, Log-Rank test, checking proportional hazard assumptions, Cox regression model parameter estimation, backward selection with AIC, the best model parameter significance test, calculating Hazard ratio and interpretation of each predictor variable. Based on the results of the analysis and discussion, it was found that for the Log-Rank test, the variable survival time for domestic violence, forced marriage, lying and stories of disgrace differed significantly. While the model that meets the criteria after iteration up to 15 times is the 15th model with the smallest AIC value and p-value <0.05 with factors that significantly influence divorce in Pelaihari sub-district based on modeling results using Cox proportional Hazard regression. are the variables of cheating, gambling, domestic violence, forced marriage, lies, jealousy and disgrace story variables

scholarly journals Survival Analysis of Duration of exclusive breastfeeding in Ethiopia: Comparison of Proportional Hazard model and Accelerated Failure Time models

2021 ◽  
Author(s):  
Bacha Ewunetu Gemechu ◽  
Tilahun Bedaso Merga
Keyword(s):  
Failure Time ◽  
Mode Of Delivery ◽  
Wealth Index ◽  
Rank Test ◽  
Accelerated Failure Time ◽  
Proportional Hazard ◽  
Aft Model ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Accelerated Failure

Abstract Introduction Early cessation of EBF has the short and long term effect for the welfare of infants including the life-long impacts of poor school performance, reduced productivity, and impaired intellectual development. Objective of the study: the main objective of this study was to compare the performance of CPH model and AFT models in analyzing EBF data in Ethiopia, 2016 EDHS. Specifically, the study aimed to identify the major predictor variables of the duration of EBF based on 2016 EDHS data.Methodology: The secondary data is obtained from Ethiopian Demographic and Health Survey (EDHS), 2016. The outcome variable of this study was the duration of EBF in month. To achieve the objective of the study, descriptive survival analysis like the median survival time, Kaplan Meier survival estimate and log-rank test were used to compare the estimated survival probability among different levels of predictor variables at 5 percent significant level. The Cox proportional hazard regression and Accelerated failure time model were fitted and their results were compared using model comparison criterion such as AIC, BIC.Results: of 1092 interviewed mothers, 15.3 % of them were discontinued EBF and 84.7% of them were exclusively breastfed (censored). The estimated median duration of EBF was 3 months. Based on estimated Kaplan Meier survival curve and log-rank test, it was found that there was a statistically significant difference in survivor experience of discontinuing EBF over each duration with respect to place of delivery, maternal education, husband education, mode of delivery and employment status. The fitted CPH and AFT model indicated that mode of delivery, wealth index, and employment status was found as significant predictors of EBF duration. Moreover, comparatively Weibull AFT model performed better in analyzing EBF data. According to the fitted model, mothers who were in poor wealth index category and who gave birth by cesarean shortens the duration of EBF by 16% and 29% respectively. On the other hand, employed mothers were improved the duration of EBF by 26%. Conclusion: Weibull AFT model is performed better in analyzing EBF data. A mother who was unemployed, poor wealth index, and gave birth by cesarean shortens the duration of EBF than their counterparts. Therefore, special emphasis should be given for mothers who are unemployed, who are economically poor, and give birth by cesarean to improve the duration of EBF.

Combined adjuvant cisplatin and ifosfamide chemotherapy and radiotherapy for malignant mixed müllerian tumors of the uterus

2006 ◽  
Vol 16 (3) ◽  
pp. 1364-1369 ◽  
Author(s):  
L. Wong ◽  
H. T. See ◽  
H. S. Khoo-Tan ◽  
J. S. Low ◽  
W. T. Ng ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Rank Test ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Effect Of Treatment ◽  
Cox Proportional Hazard Regression

The role of adjuvant therapy for malignant mixed müllerian tumors of the uterus has not been established. Our aim was to review our experience with sequential adjuvant therapy using cisplatin and ifosfamide chemotherapy and radiotherapy after surgical staging. A retrospective study of 43 patients from 1995 to 2004 was undertaken. Survival was calculated using the Kaplan–Meier method and compared by the log-rank test. The Cox proportional hazard regression model was used to assess the effect of treatment on survival after adjustment for age and stage. Twenty-eight patients received adjuvant chemotherapy and 28 patients had adjuvant radiotherapy. Twenty-one patients underwent sequential adjuvant chemotherapy and radiotherapy. Tumor recurrence occurred in 14 patients at a median duration of 10 months. The overall 2- and 5-year survival was 64% and 60%, respectively. The 2- and 5-year survival for stage I and II diseases was both 95%, while the 2-year survival for stage III and IV diseases was 25%. Patients who underwent sequential adjuvant therapy had an improved survival compared with patients who did not follow the protocol (P = 0.024). Our results with sequential adjuvant therapy are encouraging and justify future randomized trials.

Colorectal Liver Metastases - Does the Number of Lesions Determine the Sensibility of Resection?

Swiss Surgery ◽  
2000 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Knoefel ◽  
Brunken ◽  
Neumann ◽  
Gundlach ◽  
Rogiers ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Chirurgische Entfernung

Die komplette chirurgische Entfernung von Lebermetastasen bietet Patienten nach kolorektalem Karzinom die einzige kurative Chance. Es gibt jedoch eine, anscheinend unbegrenzte, Anzahl an Parametern, die die Prognose dieser Patienten bestimmen und damit den Sinn dieser Therapie vorhersagen können. Zu den am häufigsten diskutierten und am einfachsten zu bestimmenden Parametern gehört die Anzahl der Metastasen. Ziel dieser Studie war es daher die Wertigkeit dieses Parameters in der Literatur zu reflektieren und unsere eigenen Patientendaten zu evaluieren. Insgesamt konnte von 302 Patienten ein komplettes Follow-up erhoben werden. Die gebildeten Patientengruppen wurden mit Hilfe einer Kaplan Meier Analyse und konsekutivem log rank Test untersucht. Die Literatur wurde bis Dezember 1998 revidiert. Die Anzahl der Metastasen bestätigte sich als ein prognostisches Kriterium. Lagen drei oder mehr Metastasen vor, so war nicht nur die Wahrscheinlichkeit einer R0 Resektion deutlich geringer (17.8% versus 67.2%) sondern auch das Überleben der Patienten nach einer R0 Resektion tendenziell unwahrscheinlicher. Das 5-Jahres Überleben betrug bei > 2 Metastasen 9% bei > 2 Metastasen 36%. Das 10-Jahres Überleben beträgt bislang bei > 2 Metastasen 0% bei > 2 Metastasen 18% (p < 0.07). Die Anzahl der Metastasen spielt in der Prognose der Patienten mit kolorektalen Lebermetastasen eine Rolle. Selbst bei mehr als vier Metastasen ist jedoch gelegentlich eine R0 Resektion möglich. In diesen Fällen kann der Patient auch langfristig von einer Operation profitieren. Das wichtigere Kriterium einer onkologisch sinnvollen Resektabilität ist die Frage ob technisch und funktionell eine R0 Resektion durchführbar ist. Ist das der Fall, so sollte auch einem Patienten mit mehreren Metastasen die einzige kurative Chance einer Resektion nicht vorenthalten bleiben.

scholarly journals Sarcomas de alto grau: estudo retrospectivo de 131 casos

2008 ◽  
Vol 35 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Wilmar José Manoel ◽  
Bruno José de Queiroz Sarmento ◽  
Luiz de Paula Silveira Júnior ◽  
Deidimar Cássia Batista de Abreu ◽  
Iron Pires de Abreu Neto ◽  
...  
Keyword(s):  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier

OBJETIVO: Relatar as características clínicas dos sarcomas de partes moles de alto grau e apresentar a experiência do Hospital Araújo Jorge no tratamento destes sarcomas. MÉTODO: Análise retrospectiva dos casos de sarcoma de alto grau em adultos admitidos no Hospital Araújo Jorge (HAJ) entre 1996 e 2000. Idade, sexo, características anátomo-patológicas (tamanho e tipo histológico), localização, tratamentos oncológicos realizados (cirurgias de preservação de órgãos e membros, margens, quimioterapia, radioterapia), recorrência local, recorrência distante e sobrevida foram estudados. Análise descritiva, curvas de Kaplan-Meier, log-rank test e teste ÷² foram usados quando pertinentes. RESULTADOS: Foram registrados 235 pacientes com sarcomas de partes moles entre 1996 - 2000, sendo que 131 eram de alto grau. A média de idade foi de 47,2 anos. O tipo histológico não foi determinado em 23,7% dos casos. O tipo mais freqüente foi o leiomiossarcoma (13,7%), seguido do sarcoma sinovial (10,7%) e rabdomiossarcoma (9,2%). O tamanho mediano foi de 10 cm (2-48 cm). A distribuição nos estádios II,III e IV foi de 15%, 55% e 30%, respectivamente. Nos pacientes com estádios II e III, a margem cirúrgica adequada foi obtida em 51,9% dos pacientes. Radioterapia e quimioterapia adjuvantes foram indicadas em 33,7% e 26,1% dos casos, respectivamente. As recorrências locais e distantes ocorreram em 31,5% e 34,8% dos pacientes, respectivamente. A sobrevida global em 5 anos foi 61,8%. CONCLUSÃO: A maioria dos pacientes atendidos no HAJ é portadora de lesões localmente avançadas, volumosas ou com metástase ao diagnóstico. Os pacientes apresentaram evolução adversa, com altas taxas de recorrência local e distante.

P850Clinical difference of recent myocardial infarction compared with acute myocardial infarction - Insights from Tokyo CCU network multicenter registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Ito ◽  
M Takayama ◽  
J Yamashita ◽  
K Yahagi ◽  
T Shinke ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Cause Of Death ◽  
Rank Test ◽  
Mechanical Complication ◽  
Recent Myocardial Infarction ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Multicenter Registry

Abstract Background Although the patient's characteristics and outcome of acute myocardial infarction (AMI) have been sufficiently investigated and primary percutaneous coronary intervention (PCI) has been recognized as established treatment strategy, those of recent myocardial infarction (RMI) have not been fully evaluated. Purpose The purpose of the present study was to clarify clinical characteristics and in-hospital outcomes of RMI patients from the database of the Tokyo CCU network multicenter registry. Methods In Tokyo CCU network multicenter registry database from 2013 to 2016, 15788 consecutive patients were registered as AMI (within 24 hours from onset) and RMI (within 2–30 days from onset). However 1246 patients were excluded because of inadequate data. And we excluded 66 cases because of out of onset period and 129 cases that strongly suspected of involvement of vasospastic events. Therefore, remaining 14347 patients were categorized to RMI group (n=1853) and AMI group (n=12494), and analyzed. Results Compared with AMI group, average age was older (70.4±12.9 vs 68.0±13.4 years, p<0.001), male was less (72.4 vs 76.4%, p<0.001), chest pain as chief complaint was less (75.2 vs 83.6%, p<0.001), prevalence of diabetes mellitus was higher (35.9 vs 31.0%, p<0.001), multi-vessel coronary disease was more (54.7 vs 44.6%, p<0.001), patients undergoing PCI was less (79.0 vs 91.2%, p<0.001), and the incidence of mechanical complication was more in RMI group (3.0 vs 1.5%, p<0.001). Although 30-day mortality was equivalent between 2 groups (5.3 vs 5.8%, p=0.360), the major cause of death in AMI group was cardiogenic shock, while in the RMI group it was a mechanical complication. On Kaplan-Meier analysis, the 2 groups had significantly different cumulative incidence of death due to cardiogenic shock (p=0.006, Log-rank test) and mechanical complication (p=0.021, Log-rank test). Furthermore death due to mechanical complication in AMI group was plateau after about 1 week from hospitalization, whereas in RMI group it continued to increase. Kaplan-Meier analysis Conclusions RMI patients had distinctive clinical features in backgrounds and treatment strategies compared with AMI patients, and the major cause of death of RMI patients was different from that of AMI patients. Furthermore, even though treatment during hospitalization of RMI patients was well done, death due to mechanical complications continued to increase.

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