The predictive factor of mortality and prognosis of cardiovascular patients admitted at coronary care unit

Shin, Eun Suk; Jeong, Myung Ho; Kim, Kye Hun; Ji, Sun Il; Shin, Ji Heo; Lee, Eun Jeong; Hong, Young Joon; Park, Hyung Wook; Kim, Ju Han; Kim, Weon; Ahn, Young Keun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

Abstract

BACKGROUND: The mortality rate of cardiovascular patients has been decreased after the introduction of coronary care unit (CCU), however data about that of Korean patients is rare.
METHODS
Two thousand and eighty one patients (63.6+/-14.6 years, 1,295 male), who were admitted at CCU of Chonnam National University Hospital between January 2002 and June 2004, were analyzed. The admitted patients were divided into two groups: the survival group (Group I: n=1,926, 1,205 male, 62.3+/-13.9 years) and the death group (Group II: n=155, 90 male, 64.9+/-15.3 years). Clinical characteristics, risk factors for atherosclerosis, laboratory, echocardiographic and coronary angiographic findings were compared between the two groups.
RESULTS
The overall mortality at CCU was 7.4% (155 out of 2,081 patients). Mean age and sex ratio were not different between the two groups. Coronary artery disease was the most common causes of both admission (1,606 out of 2,081 patients) and death (107 out of 155 patients). The clinical diagnoses of group II were myocardial infarction (n=70), unstable anginas (n=30), variant angina (n=2), congestive heart failure (n=17), aortic dissection (n=14) and arrhythmia (n=34). Left ventricular ejection fraction (LVEF) by echocardiogram was higher in Group I than in Group II (56.2+/-20.7% vs. 42.6+/-17.1%, p<0.001). Predictive factors for mortality according to multiple logistic regression analysis were low LVEF, use of intra-aortic balloon pump (IABP), inability to perform percutaneous coronary intervention (PCI) and high level of myoglobin.
CONCLUSIONS
Death due to acute coronary syndrome was most common cause of CCU mortality. Decreased LVEF, insertion of IABP, inability to perform PCI and high myoglobin were associated with mortality of CCU admitted patients.