Impact factors of short-term prognosis in very elderly patients (aged 80 years and older) with acute myocardial infarction: multivariate logistic regression analysis

Objective

To investigate the impact factors of short-term prognosis in very elderly patients (aged 80 years and older) with acute myocardial infarction (AMI).

Methods

One hundred and twenty-three very elderly patients with AMI were admitted to the Chinese PLA General Hospital from 1 January 1993 to 31 August 2002. Patients were divided into two groups. The patients in group A died and the patients in group B were alive in hospital within 30 days. Their clinical characteristics, risk factors, clinical presentation, treatment and complications were analyzed.

Results

Twenty-six patients died of AMI within 30 days. Univariate analysis indicated that histories of diabetes, prior myocardial infarction and cerebral infarction, high white blood cell count (≥ 10 × 10⁹/l), low left ventricular ejection fraction (< 50%), inhospital complications including arrhythmia, pump failure and pneumonia, as well as the therapy without aspirin were significantly associated with the inhospital mortality within 30 days. Multivariate logistic regression analysis, using mortality as the dependent variable and using the history, inhospital complications and so on as the independent variable, showed that the major determinants of the inhospital mortality were the histories of diabetes (odds ratio = 3.58, 95% confidence interval [CI] = 1.08-11.90) and cerebral infarction (odds ratio = 6.82, 95% CI = 1.55-29.98), and inhospital complication of pump failure (odds ratio = 13.11, 95% CI = 3.84-44.78).

Conclusions

These findings demonstrate that the histories of diabetes and cerebral infarction, as well as inhospital complication of pump failure were the independent impact factors of short-term prognosis in very elderly patients with AMI.