Background : Acute Myocardial Infarction which is the major cause of death in older patients is increasing incidence continuously in Korea. The aim of this study is to analyze the factors which influence mortality of acute myocardial infarction patients over 65 years of age.
Method : We reviewed the medical records of 117 patients of Acute myocardial infarction who had been admitted in the department of Internal medicine, National Medical Center, between January, 1995 and December, 1999 An analysis was done on age and sex distribution, mortality, use of thrombolytics, and coexistent disease, and then, we analyzed the above factor to know whether they influence mortality rate or not.
Result :
1) The mortality of acute myocardial infarction was 18% and factors which influence mortality were age, prehospital delay, use of thrombolytics and coexistent disease.
2) Prehospital delay rate in the patient over 65 years and under 65 years were 52.7% and 33.3%, respectively, we thought that as the age of patient was increasing, there is the prehospital delay.
3) There was no difference of mortality by the age in the group which had the prehospical delay
4) The rate of thrombolytics adminstration in th patient over 65 years old and under 65 years old were 69% & 14%, respectely, We thought that as the age of patient was increasing, there was reduction of thrombolytics usage.
5) Only single prehospital delay couldn´t increase the mortality rate.
6) There were more heart failure, arrhythmia, cerebrovascular disease and history of shock in the patient over 65 years old.
Conclusion : For the reduction of mortality of acute myocardial infarction,education of patient & relatives to minimize the prehospital delay, prompt evaluation & examination of patientand active consideration of thrombolytics must be done.
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