Rashid, H., Elkeshk, E., Mostafa, S., Hassanien, A. (2021). Predictors of In-Hospital Outcome in Initially Hemodynamially Stable Adults with Non–STSegment–Elevation Myocardial Infarction. Benha Journal of Applied Sciences, 6(6), 251-258. doi: 10.21608/bjas.2021.214817
H.K. Rashid; E.S. Elkeshk; S.A. Mostafa; A.S. Hassanien. "Predictors of In-Hospital Outcome in Initially Hemodynamially Stable Adults with Non–STSegment–Elevation Myocardial Infarction". Benha Journal of Applied Sciences, 6, 6, 2021, 251-258. doi: 10.21608/bjas.2021.214817
Rashid, H., Elkeshk, E., Mostafa, S., Hassanien, A. (2021). 'Predictors of In-Hospital Outcome in Initially Hemodynamially Stable Adults with Non–STSegment–Elevation Myocardial Infarction', Benha Journal of Applied Sciences, 6(6), pp. 251-258. doi: 10.21608/bjas.2021.214817
Rashid, H., Elkeshk, E., Mostafa, S., Hassanien, A. Predictors of In-Hospital Outcome in Initially Hemodynamially Stable Adults with Non–STSegment–Elevation Myocardial Infarction. Benha Journal of Applied Sciences, 2021; 6(6): 251-258. doi: 10.21608/bjas.2021.214817
Predictors of In-Hospital Outcome in Initially Hemodynamially Stable Adults with Non–STSegment–Elevation Myocardial Infarction
Cardiology, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt
Abstract
Facts: The ICU utilisation for initially stable patients with non–ST-segment–elevation myocardial infarction (NSTEMI) varies greatly between institutions and correlates weakly with disease severity. ICU resources are limited, yet high-risk patients must be cared for in a safe manner, and this study aims to predict if a patient with NSTEMI who is initially stable is likely to need ICU care. Methods: a cross-sectional investigation with a single central point. This research comprised 500 adult patients of both sexes with NSTEMI who were admitted to the National Heart Institute's coronary care unit for evaluation. 58 percent of our patients were males, with a mean age of 59.4413.89 years old, according to our findings (range: 32-88). As far as their medical history goes, 72% had hypertension, 58% had dyslipidemia, 46% were diabetics, 26% had a prior heart attack, 24% had chronic obstructive pulmonary disease, and 14% were drug abusers. 56% were smokers, and 56% had a favourable hospital admission history. Patients with ACTION ICU risk scores ranging from 1 to 14 had a risk of problems needing ICU care of 3.3% to 39.3%, with a mean value of 20.4813.23. The ACTION ICU score performed better than the GRACE risk score in predicting problems that need ICU treatment. With a cut-off value of >15, the Action ICU risk score had an AUC of 0.931, 96.2 percent sensitivity, 91.7 percent specificity, and 92.6 percent positive and negative predictive values. HTN, PCI, CABG, Stroke and PVD were shown to be associated with a higher risk of death. Age (years), HTN, Prior PCI, Prior CABG and Prior Stroke were also found to be associated with an increased risk of death. We found that 13.6 percent of NSTEMI patients who acquired a state needing ICU-level care died without ever being admitted to the ICU. Conclusion: Among patients with NSTEMI who were hemodynamically stable, the ACTION ICU risk score demonstrated strong capacity to predict the likelihood of developing problems requiring ICU-level care. With this score, hospitals may efficiently minimise the usage of ICU resources while ensuring sufficient care is given to high-risk patients.
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