PHÂN TÍCH ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ YẾU TỐ TIÊN LƯỢNG TỬ VONG Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CÓ SỐC TIM TẠI BỆNH VIỆN ĐA KHOA XANH PÔN

Abstract

Objective: To describe the clinical and paraclinical characteristics and identify prognostic factors in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock. Methods: A retrospective cross-sectional study was performed on 30 patients with AMI and cardiogenic shock treated at the Emergency Department of Saint Paul Hospital from April to Oct 2022. Clinical, laboratory, treatment, and outcome data were analyzed using descriptive statistics and the Chi-square test (p<0.05). Results: The mean age was 75.5 ±13.6 years; 53.3% were ≥75 years and 66.7% were male. Hypertension (73.3%) and diabetes mellitus (26.7%) were common comorbidities. Cardiac arrest occurred in 50%, and early shock within 48 hours in 76.7%. Mean lactate was 9.4 ± 6.0 mmol/L and pH 7.30 ± 0.18; 10% had LVEF<30%. All required vasopressors, 66.6% mechanical ventilation, 13.3% coronary angiography, and 6.6% stent implantation. Mortality or severe outcome reached 60%. Independent predictors of mortality were cardiac arrest, lactate ≥ 4 mmol/L, and absence of coronary intervention (p <0.05). Conclusion: Patients with acute myocardial infarction complicated by cardiogenic shock in our study were predominantly elderly with multiple comorbidities and had a high mortality rate. Elevated lactate levels, cardiac arrest, and the absence of coronary revascularization were identified as adverse prognostic factors. Early recognition of cardiogenic shock and timely implementation of coronary reperfusion when indicated are essential to improving clinical outcomes