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Risk of perioperative death and sudden cardiac arrest: a study of 113 456 cases from the National Registry of Invasive Cardiology Procedures (ORPKI) for estimation of the perioperative prognosis

Janusz Sielski1, Karol Kaziród-Wolski1, Zbigniew Siudak1
DOI: 10.33963/KP.a2021.0133
·
Pubmed: 34643263
Affiliations
  1. Collegium Medicum, Jan Kochanowski University, Kielce, Poland

open access

Online first
Original article
Published online: 2021-10-12

Abstract

Background: Despite optimizing treatment of ST-segment elevation myocardial infarction (STEMI) a lot of patients die during the invasive procedure or experience sudden cardiac arrest (SCA) that complicates further hospitalization.
Aims: The aim of the study was to identify the most important risk factors leading to SCA and death in the cath lab among STEMI patients.
Methods: We used the National Registry of Invasive Cardiology Procedures (ORPKI) between 2014 and 2019. The study population consisted of 113 465 patients. Descriptive statistics univariate and multiple logistic regression analysis of factors affecting perioperative mortality (PM) and SCA in the cath lab were performed.
Results: Death and SCA occurred in 1549 (1.4%) and 945 (0.8%) patients, respectively. Diabetes (odds ratio [OR] 1.76; P <0.0001), previous brain stroke (OR 2.26; P <0.0001), prior myocardial infarction (OR 1.81; P <0.0001), psoriasis (OR 1.79; P = 0.04) and chronic renal failure (OR 2.79; P <0.0001) were the strongest predictors of PM. The occurrence of SCA was dependent mainly on diabetes (OR 1.37; P = 0.0001), previous brain stroke (OR 2.23; P <0.0001), prior myocardial infarction (OR 1.73; P <0.0001), psoriasis (OR 2.03; P = 0.04), chronic renal failure (OR 2.79; P <0.0001). Of the pre-hospital factors, the Killip–Kimball class showed the strongest relationship with the two endpoints (OR 3.53; P <0.0001 and OR 2.65; P <0.0001).
Conclusions: Diabetes, previous brain stroke and myocardial infarction, psoriasis, chronic renal failure and the Killip–Kimball class were the strongest predictors of PM and SCA in the cath lab.

Abstract

Background: Despite optimizing treatment of ST-segment elevation myocardial infarction (STEMI) a lot of patients die during the invasive procedure or experience sudden cardiac arrest (SCA) that complicates further hospitalization.
Aims: The aim of the study was to identify the most important risk factors leading to SCA and death in the cath lab among STEMI patients.
Methods: We used the National Registry of Invasive Cardiology Procedures (ORPKI) between 2014 and 2019. The study population consisted of 113 465 patients. Descriptive statistics univariate and multiple logistic regression analysis of factors affecting perioperative mortality (PM) and SCA in the cath lab were performed.
Results: Death and SCA occurred in 1549 (1.4%) and 945 (0.8%) patients, respectively. Diabetes (odds ratio [OR] 1.76; P <0.0001), previous brain stroke (OR 2.26; P <0.0001), prior myocardial infarction (OR 1.81; P <0.0001), psoriasis (OR 1.79; P = 0.04) and chronic renal failure (OR 2.79; P <0.0001) were the strongest predictors of PM. The occurrence of SCA was dependent mainly on diabetes (OR 1.37; P = 0.0001), previous brain stroke (OR 2.23; P <0.0001), prior myocardial infarction (OR 1.73; P <0.0001), psoriasis (OR 2.03; P = 0.04), chronic renal failure (OR 2.79; P <0.0001). Of the pre-hospital factors, the Killip–Kimball class showed the strongest relationship with the two endpoints (OR 3.53; P <0.0001 and OR 2.65; P <0.0001).
Conclusions: Diabetes, previous brain stroke and myocardial infarction, psoriasis, chronic renal failure and the Killip–Kimball class were the strongest predictors of PM and SCA in the cath lab.

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Keywords

periprocedural mortality, risk factors, STEMI

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Title

Risk of perioperative death and sudden cardiac arrest: a study of 113 456 cases from the National Registry of Invasive Cardiology Procedures (ORPKI) for estimation of the perioperative prognosis

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-10-12

DOI

10.33963/KP.a2021.0133

Pubmed

34643263

Keywords

periprocedural mortality
risk factors
STEMI

Authors

Janusz Sielski
Karol Kaziród-Wolski
Zbigniew Siudak

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