Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome in Hasan Sadikin Hospital, Bandung, Indonesia: A Retrospective Cohort Study

Background: Acute coronary syndrome (ACS) is a world health problem with a high mortality rate and is expected to continue to rise in number. The high ACS mortality rate in the hospital is influenced by demographic characteristics, cardiovascular risk factors, clinical presentation, and management....

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Main Authors: Miftah Pramudyo, Achmad Fauzi Yahya, Erwan Martanto, Badai B Tiksnadi, Giky Karwiky, Raissa Rafidhinar, Gemi Nastiti Indi Putri
Format: Article
Language:English
Published: Interna Publishing 2022-09-01
Series:Acta Medica Indonesiana
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Online Access:http://www.actamedindones.org/index.php/ijim/article/view/2036
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author Miftah Pramudyo
Achmad Fauzi Yahya
Erwan Martanto
Badai B Tiksnadi
Giky Karwiky
Raissa Rafidhinar
Gemi Nastiti Indi Putri
author_facet Miftah Pramudyo
Achmad Fauzi Yahya
Erwan Martanto
Badai B Tiksnadi
Giky Karwiky
Raissa Rafidhinar
Gemi Nastiti Indi Putri
author_sort Miftah Pramudyo
collection DOAJ
description Background: Acute coronary syndrome (ACS) is a world health problem with a high mortality rate and is expected to continue to rise in number. The high ACS mortality rate in the hospital is influenced by demographic characteristics, cardiovascular risk factors, clinical presentation, and management. This study aimed to determine the predictors of ACS death at Dr. Hasan Sadikin Hospital Bandung as the highest referral center in West Java. Methods: This study is a retrospective cohort study on all ACS patients undergoing treatment at Dr. Hasan Sadikin Hospital Bandung from January 2018 to December 2019. Multivariate analysis was performed using a logistic regression test with the backward method to assess predictors of patient outcomes. Results: This study involved 919 patients with the in-hospital mortality rate was 10.6%. Multivariate analysis showed that age >65 years was a demographic factor that play a role as a predictor of mortality mortality (AOR 2.143; 95% CI = 1.079-4.256; p = 0.030). Clinical presentation of cardiac arrest arrest (AOR 48.700; 95% CI =14.289-165.980; p<0.001), SBP <90 mmHg (AOR: 4.972; 95% CI =1.730-14.293; p=0.003, heart rate >100 beats per minute (AOR 4.285; 95% CI =2.209-8.310; p<0,001), cardiogenic shock (AOR: 5.433; 95% CI= 2.257-13.074; p<0.001). Cardiovascular management can reduce the risk of in-hospital mortality. Multivariate analysis showed statins (AOR 0.155; 95% CI=0.040-0.594; p=0.007), beta blockers (AOR 0.304; 95% CI=0.162-0.570; p<0,001) and Percutaneous Coronary Intervention (AOR 0.352; 95% CI=0.184-0.673; p=0.002) significantly reduce in-hospital mortality. Interestingly, smoking is associated with a lower mortality rate (OR 0.387; p <0.001). Conclusion: Clinical presentation of cardiac arrest has the highest risk of death, the sequence is cardiogenic shock, heart rate >100 beats per minute, and age >65 years. Administration of statins, beta-blockers, PCI, and smoking are factors that reduce the risk of death.
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spelling doaj-art-d284f30ebd904d26abd641136e6aa3af2025-08-20T03:50:00ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322022-09-01543Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome in Hasan Sadikin Hospital, Bandung, Indonesia: A Retrospective Cohort StudyMiftah Pramudyo0Achmad Fauzi Yahya1Erwan Martanto2Badai B Tiksnadi3Giky Karwiky4Raissa Rafidhinar5Gemi Nastiti Indi Putri6Department of Cardiology and Vascular Medicine, Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Cardiology and Vascular Medicine, Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Cardiology and Vascular Medicine, Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Cardiology and Vascular Medicine, Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Cardiology and Vascular Medicine, Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Cardiology and Vascular Medicine, Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Cardiology and Vascular Medicine, Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, IndonesiaBackground: Acute coronary syndrome (ACS) is a world health problem with a high mortality rate and is expected to continue to rise in number. The high ACS mortality rate in the hospital is influenced by demographic characteristics, cardiovascular risk factors, clinical presentation, and management. This study aimed to determine the predictors of ACS death at Dr. Hasan Sadikin Hospital Bandung as the highest referral center in West Java. Methods: This study is a retrospective cohort study on all ACS patients undergoing treatment at Dr. Hasan Sadikin Hospital Bandung from January 2018 to December 2019. Multivariate analysis was performed using a logistic regression test with the backward method to assess predictors of patient outcomes. Results: This study involved 919 patients with the in-hospital mortality rate was 10.6%. Multivariate analysis showed that age >65 years was a demographic factor that play a role as a predictor of mortality mortality (AOR 2.143; 95% CI = 1.079-4.256; p = 0.030). Clinical presentation of cardiac arrest arrest (AOR 48.700; 95% CI =14.289-165.980; p<0.001), SBP <90 mmHg (AOR: 4.972; 95% CI =1.730-14.293; p=0.003, heart rate >100 beats per minute (AOR 4.285; 95% CI =2.209-8.310; p<0,001), cardiogenic shock (AOR: 5.433; 95% CI= 2.257-13.074; p<0.001). Cardiovascular management can reduce the risk of in-hospital mortality. Multivariate analysis showed statins (AOR 0.155; 95% CI=0.040-0.594; p=0.007), beta blockers (AOR 0.304; 95% CI=0.162-0.570; p<0,001) and Percutaneous Coronary Intervention (AOR 0.352; 95% CI=0.184-0.673; p=0.002) significantly reduce in-hospital mortality. Interestingly, smoking is associated with a lower mortality rate (OR 0.387; p <0.001). Conclusion: Clinical presentation of cardiac arrest has the highest risk of death, the sequence is cardiogenic shock, heart rate >100 beats per minute, and age >65 years. Administration of statins, beta-blockers, PCI, and smoking are factors that reduce the risk of death. http://www.actamedindones.org/index.php/ijim/article/view/2036Hospital deathpredictoracute coronary syndrome
spellingShingle Miftah Pramudyo
Achmad Fauzi Yahya
Erwan Martanto
Badai B Tiksnadi
Giky Karwiky
Raissa Rafidhinar
Gemi Nastiti Indi Putri
Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome in Hasan Sadikin Hospital, Bandung, Indonesia: A Retrospective Cohort Study
Acta Medica Indonesiana
Hospital death
predictor
acute coronary syndrome
title Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome in Hasan Sadikin Hospital, Bandung, Indonesia: A Retrospective Cohort Study
title_full Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome in Hasan Sadikin Hospital, Bandung, Indonesia: A Retrospective Cohort Study
title_fullStr Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome in Hasan Sadikin Hospital, Bandung, Indonesia: A Retrospective Cohort Study
title_full_unstemmed Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome in Hasan Sadikin Hospital, Bandung, Indonesia: A Retrospective Cohort Study
title_short Predictors of In-Hospital Mortality in Patients with Acute Coronary Syndrome in Hasan Sadikin Hospital, Bandung, Indonesia: A Retrospective Cohort Study
title_sort predictors of in hospital mortality in patients with acute coronary syndrome in hasan sadikin hospital bandung indonesia a retrospective cohort study
topic Hospital death
predictor
acute coronary syndrome
url http://www.actamedindones.org/index.php/ijim/article/view/2036
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