complicação infecciosa indica mau prognóstico no infarto agudo do miocárdio infection complication portends poor prognosis in acute myocardial infarction

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ID: 167173
2006
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Abstract
OBJETIVO: Determinar a incidência e o impacto das complicações infecciosas do infarto agudo do miocárdio (IAM) no tempo de permanência e na letalidade. MÉTODOS: Trata-se de um estudo clínico e retrospectivo, tipo caso-controle, realizado por meio de análise de prontuários. A população do estudo foi constituída por pacientes internados na Unidade Coronariana do InCor do Hospital das Clínicas da FMUSP com diagnóstico de IAM, entre janeiro de 1996 e dezembro de 1999. RESULTADOS: Foram analisados 1.227 pacientes, e sessenta (5%) preenchiam os critérios diagnósticos de complicação infecciosa do IAM (grupo infectados). Os demais 1.167 pacientes constituíram o grupo controle. A média das idades (67,5 versus 62,6 anos), o tempo de permanência hospitalar (26,6 versus 12,0 dias) e a mortalidade hospitalar (45% versus 12%) foram maiores no grupo infectados. Pacientes submetidos a mais de três procedimentos invasivos apresentaram índice de mortalidade mais elevado (68% e 32%, p = 0,006). As infecções mais freqüentes foram as pulmonares (63%), do trato urinário (37%) e hemoculturas positivas sem sítio identificado (8%). CONCLUSÃO: Na população estudada, a incidência de complicação infecciosa foi de 5%. O tempo de internação prolongado e a taxa de mortalidade elevada sugerem que a complicação infecciosa tem um grande impacto sobre os pacientes internados com o diagnóstico de IAM em unidade coronariana.
OBJECTIVE: To determine both the incidence and impact of infectious complications of acute myocardial infarction (AMI) on length of hospital stay and mortality. METHODS: This is a retrospective, case-control clinical trial involving medical records review. The study population consisted of patients admitted to the Coronary Care Unit (CCU) of the Hospital das Clínicas Heart Institute of the University of São Paulo Medical School - FMUSP - with AMI between January 1996 and December 1999. RESULTS: One thousand two hundred and twenty-seven patients were analyzed, and 60 (5%) met diagnostic criteria for infectious complication of AMI (infected group). The other 1167 patients served as control group. Mean age (67.5 versus 62.6), hospital length of stay (26.6 versus 12.0 days), and in-hospital mortality (45% versus 12%) were higher in the infected group. Mortality rate was higher among patients who underwent more than three invasive procedures (68% and 32%, p = 0.006). The most frequent infections were pulmonary (63%), urinary tract (37%) and positive blood cultures with no identifiable site of infection (8%). CONCLUSION: In the population studied, infectious complication rate was 5%. Prolonged hospital stay and high mortality rate suggest that infection complication has a great impact on AMI patients admitted to the coronary care unit.
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Authors ;Leandro Carlos Grandini Júnior;Bruno Caramelli
Journal revista cubana de ciencias informáticas
Year 2006
DOI
10.1590/S0066-782X2006001600007
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2006001600007
Keywords
infection complication myocardial infarction

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