Muhammad Shahid, Muhammad Irfan, Rao Hashim Idrees, Muhammad Maqsood, Jamshad Latif, Qamar Rafiq.
In hospital Mortality and its Predictors among STEMI suffering patients trated with Streptokinase.
Pak J Med Health Sci Jan ;13(2):314-7.

Aim: To determine the in-hospital mortality rate and its predictors among acute ST elevation myocardial infarction (STEMI) suffering patients treated with Streptokinase at tertiary care hospital, Gujranwala, Pakistan. Methods: This was a cross-sectional study conducted in the Department of Cardiology, GMC Teaching hospital, Gujranwala from June 2017 to May 2018. The data was collected by purposive sampling after written informed consent. The patients admitted with STEMI, of both genders, and all age groups, who were treated with Streptokinase injection were included. Statistical analysis was done using SPSS version 25. Independent sample T test and Chi-square test for independence were used for quantitative and qualitative variables respectively to determine the significant factors associated with in-hospital mortality. Results: In-hospital mortality rate among 668 STEMI patients was 3.7%. The group of patients who died had a statistically significantly higher age (p=0.019), BMI (P<0.001), and serum potassium level (p=0.013). The group of patients who not died had a statistically significantly higher systolic BP (P<0.001) and diastolic BP (p=0.036) atpresentation. Death rate was also significantly higher among STEMI patients having diabetes mellitus (p=0.045), obesity (p<0.001), inferior wall involved in STEMI (p=0.014) and right ventricle involved (p<0.001) , while survivalrate was significantly higher among patients whose ST segment on ECG got settled >50% at 1st post-admission day (p<0.001).Conclusion: The STEMI patients treated with Streptokinase had an excellent survival rate and low mortality rate in our population. Increasing age and serum potassium level, and right ventricular involvement were the significant predictors of in-hospital mortality among STEMI patients in regression analysis. Higher the systolic and diastolic blood pressures at presentation and >50% settlement of elevated ST segment on ECG at first post-admission day were significantly associated with survival of these patients. It was also found that the mortality was also enhanced by increasing BMI and the presence of obesity, diabetes, hypertension, and inferior cardiac wall involvement by infarction in our patients

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