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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Acute Coronary Syndrome In Elderly ? The Difference Compared With Young In Intensive Care Unit Of A Tertiary Hospital In Western Nepal
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Acute Coronary Syndrome In Elderly ? The Difference Compared With Young In Intensive Care Unit Of A Tertiary Hospital In Western Nepal

机译：老年人急性冠脉综合征？尼泊尔西部三级医院重症监护室与年轻人的差异

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Introduction: Acute coronary syndrome (ACS), one of the commonest causes of intensive care unit (ICU) admission, casts a large burden of cost on the health care system, along with a huge mortality in the elderly population. Objectives: This study determined the difference in presentation, complication, management and outcome in elderly patients with acute coronary syndrome, as compared to the young patients. Material And Methods: Records of all patients who were diagnosed to have acute coronary syndrome, admitted to the ICU in the Manipal Teaching Hospital in the month of March 2006 to June 2007, was entered in a designated Proforma. Demographic details, clinical findings, treatment and complications were recorded. A total of 153 patients were analyzed and elderly patients (≥ 65 yrs) were compared with young patients (< 65yrs) using SPSS-10.0 software.Results: Elderly patients constituted 51% (78) of the study population, among which 46.2% (36) were females. 7.7% (6) elderly patients presented with atypical symptoms, among which syncope was the commonest. Young patients were more likely to be hypertensive as compared to the elderly patients (70.7% vs. 39.7%; p<0.001). The median time of presentation to the hospital after chest pain was comparable in the two groups: 16 hours overall, but in cases of STEMI, elderly patients were brought to the hospital comparatively late, with a median time of 15 hours (IQ 5.5 ? 72 as compared to young individuals in which median time was 7.25 hours (IQ 2.87 ? 39 hours), which was statistically significant (p=0.000). Non ST elevated myocardial infarction (NSTEMI) and ST elevated myocardial infarction (STEMI) were similar in distribution among the elderly and young patients. Complication was seen predominantly among the elderly, with 62.8 %( 49) Vs38.7% (29); p =0.03. Overall, heart failure was the commonest complication (28.2%), followed closely by arrhythmias (26.9%). Cardiogenic shock complicating STEMI resulted in high patient mortality in both the age groups. Thrombolysed patients were similar in distribution in both groups. But the success rate of thrombolysis was lower in elderly patients (50%) as compared to young patients (76.9%). Beta blockers were less commonly used in the elderly- 47.4% (34) than in young patients- 61.3% (46). A combination of aspirin and clopidogrel was also less commonly used in the elderly patients {60.3% (47) Vs 76% (57); p=0.03}. Mortality was higher in the elderly patients (24.4% Vs 10.7%; p =0.03) Conclusion: Elderly patients are more prone to complications, have less success rate for thrombolysis and have a higher mortality rate as compared to young patients of ACS.
机译：简介：急性冠状动脉综合症（ACS）是重症监护病房（ICU）入院的最常见原因之一，给医疗保健系统带来了沉重的成本负担，并给老年人带来了巨大的死亡率。目的：本研究确定了老年急性冠状动脉综合征患者与年轻患者相比，在表现，并发症，治疗和预后方面的差异。材料和方法：2006年3月至2007年6月在Manipal教学医院接受ICU诊治的所有诊断为急性冠脉综合征的患者的记录均输入指定的形式表。记录人口统计学细节，临床发现，治疗和并发症。使用SPSS-10.0软件对153例患者进行了分析，并将老年患者（≥65岁）与年轻患者（<65岁）进行了比较。结果：老年患者占研究人群的51％（78），其中46.2％ ％（36）是女性。 7.7％（6）老年患者表现出非典型症状，其中晕厥最为常见。与老年患者相比，年轻患者更可能患有高血压（70.7％，而39.7％; p <0.001）。两组在胸痛后到医院就诊的中位时间相当：两组共16小时，但在STEMI病例中，老年患者被送往医院的时间相对较晚，中位时间为15小时（IQ 5.5？72与中位时间为7.25小时（IQ 2.87？39小时）的年轻个体相比，这具有统计学意义（p = 0.000）。在老年人和年轻人中，并发症多见于老年人，占62.8 ％（49）Vs38.7 ％（29）; p = 0.03。总体而言，心力衰竭是最常见的并发症（28.2％ ），紧随其后的是心律不齐（26.9％），心源性休克并发STEMI导致两个年龄段的患者死亡率都很高，两组中溶栓的患者分布相似，但老年患者的溶栓成功率较低（ 50 ％）作为补偿青年患者（76.9％）。老年患者使用β受体阻滞剂的比例较低（47.4％），而年轻患者则较少（61.3％）（46）。阿司匹林和氯吡格雷的组合在老年患者中也较少使用{60.3 ％（47）比76％（57）; p = 0.03}。老年患者的死亡率较高（24.4％，相对于10.7％，p = 0.03）。结论：与年轻患者相比，老年患者更容易发生并发症，溶栓成功率较低，死亡率更高。 ACS。

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