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RISS 인기검색어
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- 저자 : 김상우(Sang Wo Kim) (검색결과 1 건)
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전두수(Doo Soo Jeon),정해억(Hae Uk Chung),승기배(Ki Bae Seung),강동헌(Dong Hun Kang),김상우(Sang Wo Kim),김용주(Young Ju Kim),채장성(Jang Sung Chae),김재형(Jae Hyung Kim),홍순조(Soon Jo Hong),최규보(Kyu Bo Choi) 대한내과학회 1996 대한내과학회지 Vol.50 No.6
N/A Objectives: Cardiogenic shock resulting from acute myocardial infarction is a serious complication with high mortality. The early identification of patients at high risk of developing post-infarction cardiogenic shock might allow early intervention in an attempt to prevent cardiogenic shock and to reduce the mortality due to cardiogenic shock. The aim of the present study was to examine the risk factors of inhospital development of cardiogenic shock among patients with acute myocardial infarction. Methods: We studied 152patients with acute myocardial infarction who were admitted to Kang-Nam St. Mary's hospital within 24hours after the onset of chest pain and did not have cardiogenic shack on admission between March 1991 and May 1994. Clinical data of these patients were analyzed. Results: Of 152patients, 17(11.1%) developed cardiogenic shock during their hospital stay. Cardiogenic shock developed in 53% of cases more than 24hours after admission. 82.4% of patients with cardiogenic shock died whereas a 6.7% in-hospital mortality was found among patients without cardiogenic shock. Multivariate regression analysis that controlled for variables affecting incidence of postinfarction cardiogenic shock showed that independent risk factors for in-hospital cardiogenic shock were history of myocardial infarction (adjusted relative odds[RO]=5.294, 95% confidence interval[CI]=2.149 to 13.041); heart failure on admission (RO=3.344, 95% CI=1.738 to 6.432); hyperglycemia (>180mg/dl) in non-diabetic patients (RO=3.270, 95% CI=1,590 to 6.727); age over 70 year old (RO=2.912, 95% CI= 1.816 to 4.668); ST deviation over 4mm (RO=2.417, 95% CI=1.225 to 4.767); peak LDH level greater than 1600U/ml (RO=1.154, 95% CI=1.080 to 1.233). Patients with one independent risk factor had an estimated probability of 10.5% for developing inhospital cardiogenic shock; patients with two independent risk factors, 48.5%, patients with three risk factors, 65.0% patients with four risk factors, 65.7% patients with five risk factors, 67.2%. Conclusion: Of post-infarction cardiogenic shock during admission, 53% developed more than 24hours after admission. The more independent risk factors on admission for inhospital cardiogenic shock patients with acute myocardial infarction had, the more likely in-hospital cardiogenic shock developed.
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