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Tratamento e Letalidade Hospitalar do
Infarto Agudo do Miocardio na região Metropolitana de Vitória
Romildo Luiz Monteiro Andrade
Versão Português
Introduction : The
cardiovascular mortality, including Acute Myocardial Infarction,
occupies a leading position in population death cause in the
Metropolitan Area of Vitoria in the last five years.
Characterization of this condition and implementation of
strategies to detect and control its occurrence in this
population should be a priority of health policy programs.
Objectives:
To determine the lethality rate and characteristics of the acute
myocardial infarction events occurring in the population
assisted by public and private hospitals in Metropolitan Region
of Vitória-ES.
Specific Objectives: Characterization of
the main category of event presentation: fatal and not fatal;
primary or recurrent; time elapsed between symptoms onset,
clinical, enzymatic and electrocardiographic diagnosis;
in-hospital management: coronary care unit, general emergency
unit, hospital room and others, medical care and therapy;
identification of risk factors and comorbidities (smoking habits,
hypertension and diabetes) in affected subjects and compare our
results with national and international data.
Methodology:
The study covered all acute coronary events occurring in
population (1.900.000) resident in Metropolitan Region of
Vitoria-ES during July First, 1999 through July, Thirty 2000, in
subjects 25 years or older. All hospitals inside this
geographical area were contacted and joined the Epidemiological
Surveillance Network for acute coronary event. After event
detection, data was collected according to protocols adapted
from the Monitoring International Trends and Determinants of
Cardiovascular Disease (Monica) study. Event report included
detailed information about clinical presentation, medical care,
and clinical outcome. Data were examined with occurrence tables,
distribution of frequency of cases, rates and proportions of
fatal and non-fatal events. Data were stratified by gender, city
of residence of subject (Vitoria, Vila Velha, Cariacica and
Serra), kind of hospital unit (publics or private) and survival
of subjects. Chi-squared, Exact Fisher Test and Odds
rate were used to compare data in these categorities.
Results:
The main joined results had been: coefficient of lethality for
the average period of pursuing of 97 days was of 21,68%, the
hospital Lethality was of 17,21%. Smoking habit was found in
39,1%. The Arterial Hypertension was of 33,6%. The Thrombolytic
therapy was employed in 19,1% of the cases.
Conclusion:
Infarto acute of the myocardium presented predominance in the
masculine sex in the ratio of 2,6:1. Being that in 25% of the
cases its occurs individuals with inferior age the 50 years. The
tax of hospital lethality (up to 28 days) was of 17,21% and in
the average period of path of 97 days he was 21,61%.
Angioplasty therapy was employed in
19,21% of the cases and survival rates in this case were 81,25%.
The number of ECGs were greater in
private hospital (74,1%) than public one (37,7%).
Keywords: 1) Acute Myocardial Infarction, 2) Hospital
Mortality, 3) Cardiovascular disease in the Metropolitan Region
of Victoria-ES/BR.
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