Pranas Šerpytis, Audronė Beržiūnaitė, Vilma Matelytė, Živilė Lileikienė, Agnė Andruškienė
Aim of study: to investigate the frequency of bleeding events by age, sex, location, accompanying diseases, drug combinations, and distribution of deaths among bleeding patients by gender for patients with acute myocardial infarct hospitalized to Vilnius university hospital Santariškių klinikos Cardiologic intensive care unit in 2010 – 2012 and having blood transfusions.
Materials and methods: a retrospective analysis of medical records of 223 patients treated for acute myocardial infarction. 33% patients had bleeding events, the mean age of them 75 ± 1.7 years. It was analyzed the following data of bled patients: gender, age, location of bleeding, accompanying diseases, prescribed medication combinations and mortality rate.
Results: the distribution of bleeding events by gender: 55% of women and 45% of men (p = 0.034). 63% of bled patients had hemoglobin below 90 g/l (p = 0.001). Most common bleeding was in the group of age more than 60 years old (87%) (p=0.001). A statistically reliable highest frequency of bleeding according location was gastrointestinal tract (44%) and femoral artery (30%) (p = 0.008). It was found that 81% of bled patients had accompanying diseases: 11% renal insufficiency, 26% atrial fibrillation, 19% ulcer, 15% diabetes mellitus, 10% oncological diseases (p = 0.025). It was ascertained that bleeds occurred mostly with combination of heparin, aspirin and clopidogrel prescribed – 34% (p = 0,003). The distribution of bled patients by mortality: 16% had a lethal outcome (p = 0.0076) of which women composed a higher proportion than men, respectively – 58% and 42%.
Conclusions: the bleeding in the intensive care unit mainly occurred in > 60 years age group of patients, patients with accompanying diseases, female representatives, as regards the location, in the gastrointestinal tract and femoral artery, prescribing in combination of heparin, aspirin and clopidogrel. Death of bled patients frequently occurred to women. In case of listed risk groups the treatment with anticoagulants should be adjusted. In order to reduce the rate of complications the catheterisation through a.radialis or brachialis is recommended.
Keyword(s): bleeding, myocardial infarction, percutaneous coronary intervention, mortality rate
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