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  • Title: [Automatic processing of clinical information related to 2334 myocardial infarcts consecutively hospitalized at a coronary care unit].
    Author: Santos AL, Azevedo J, Melo M, Covas M, da Silva CA, Ribeiro C.
    Journal: Rev Port Cardiol; 1989 Oct; 8(10):691-8. PubMed ID: 2631817.
    Abstract:
    OBJECTIVE: Brief description of a clinical information system and its application to 2334 cases of acute myocardial infarction. DESIGN: To evaluate the influence on intra-hospital prognosis of 22 clinical characteristics observed in patients on the acute phase of myocardial infarction admitted to a coronary care unit. SETTING: Coronary care unit. PATIENTS: 2334 cases of myocardial infarction admitted sequentially to a coronary care unit. MATERIAL AND METHODS: A locally developed computerized information system was used. Software was organized in a modular way in order to turn available simplicity, flexibility and expandibility which are requisites of an automatic information system operating in a coronary unit. Following characteristics were evaluated: age and sex; previous myocardial infarction, angina, hypertension, diabetes, tabagism and hyperlipidemia; electrocardiographic localization of the infarction; ventricular dysfunction as evaluated by Killip classes; supraventricular and ventricular dysrhythmias; auriculo ventricular and intraventricular blocks; epistenocardic pericarditis; intra-hospital extension of the infarction; transient episode of hypertension and post-infarction angina. Statistical association between these characteristics and intra-hospital mortality was evaluated. Statistical significance was considered with a p less than 0.05. RESULTS: Statistical significant differences were found between surviving and non-surviving patients in the following characteristics: age and sex; previous history of myocardial infarction, angina and diabetes; Killip classes distribution; electrocardiographic localization of the infarction; intra-hospital extension of the infarction; auriculoventricular block, left and right bundle branch block; supraventricular and ventricular dysrhythmias. Patients with a previous history of tabagism and hyperlipidemia had a lesser mortality and were younger than the patients without these characteristics. Patients with transient episodes of hypertension and epistenocardic pericarditis had a lesser hospital mortality. CONCLUSIONS: Local development of a computerized information system turned available clinical information of 2334 patients sequentially admitted to a coronary care unit. A worse intra-hospital prognosis was present in the following groups of patients: older patients and females; patients with a previous history of infarction, angina and diabetes; anterior myocardial infarction, left ventricular dysfunction as evaluated by Killip classes, ventricular and supraventricular dysrhythmias, auriculoventricular and intraventricular blocks, transient episodes of hypertension and extension of the infarction. Patients with a previous history of tabagism and hyperlipidemia had a lesser mortality; however, there patients were younger than other. Patients with transient episodes of hypertension on first hours of infarction and those who had epistenocardic pericarditis had a lesser mortality.
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