CHỈ SỐ SỐC CẢI BIÊN TRONG TIÊN ĐOÁN TỬ VONG NỘI VIỆN Ở NGƯỜI BỆNH NHỒI MÁU CƠ TIM CẤP

Abstract

Background: Despite there have been many advances in prediction and risk stratification of patients with acute myocardial infarction (AMI), mortality remains a challenge for clinicians. Objectives: To study the relationship between Modified Shock Index (MSI) and the characteristics of patients with AMI, determine the mortality prognostic value of MSI and compare it with GRACE score in AMI patients. Subjects and research methods: A prospective study was conducted on 121 AMI patients, ≥18 years old, admitted to the Department of Cardiology, Cho Ray Hospital. Results: A MSI score≥1.27 was significantly and independently associated with increased rate of Killip IV classification, increased rate of left ventricular ejection fraction≤40%, increased rate of  Coronary Care Unit admission, and especially increased rate of serious illness with required discharge (3 times more than the low MSI). Receiver operating characteristic (ROC) analysis demonstrated that MSI and GRACE scores were predictors of in-hospital mortality with the AUC values of 0.67 (95%CI = 0.54 – 0.80) và 0.78 (95%CI = 0.68 – 0.89), respectively, and statistically significant difference (p=0.037). Conclusion: Although the mortality prediction model using MSI is simple and convenient in clinical practice, its effectiveness is not high enough and still inferior as compared to the GRACE score.