EMERGENCY ROOM PREDICTION OF MORTALITY AND SEVERE COMPLICATIONS IN PATIENTS WITH SUSPECTED ACUTE MYOCARDIAL-INFARCTION

This study aims at describing the in-hospital prognosis of patients ad mitted with suspected acute myocardial infarction, focusing on the pos sibility of emergency room prediction of the risk for death and severe complications. From 7157 consecutive patients with chest pain or othe r symptoms suggestive of acute myocardial infarction in the emergency room, 4690 were hospitalized. Of these, 246 (5%) died in hospital, wit h a mortality rate among the 921 patients who developed myocardial inf arction of 14%, and among those without infarction of 3%. From the cli nical history, examination and electrocardiogram in the emergency room , independent predictors of death and death or any severe complication were determined by logistic regression analysis. These included age, initial degree of suspicion of infarction, electrocardiographic patter n, history of diabetes mellitus, history of congestive heart failure a nd on admission arrhythmias, loss of consciousness, acute congestive h eart failure, or unspecific symptoms. From these analyses the probabil ity of death or death or any severe complication can be calculated. Th us, 18% of patients hospitalized due to suspected acute myocardial inf arction suffered a severe complication or died in hospital. From a sta tistical model it is possible to predict the in-hospital prognosis of every such patient.