FACTORS ASSOCIATED WITH MORTALITY OF PATIENTS WITH ACUTE CORONARY SYNDROME FROM PREHOSPITAL CARE IN THE EMERGENCY MEDICAL DEPARTMENT

Abstract

Introduction: Cardiovascular diseases are the leading causes of morbidity and mortality worldwide. One of the ways to access the hospital can be mobile pre-hospital care.  The objective of this study was to verify the risk factors for the development of death in patients with acute coronary syndrome who came from mobile prehospital care and were referred to an emergency medical service at a Hospital and University Center in Brazil. Methods: This is a prospective cohort study  of patients admitted to the emergency medical service in 2021 with acute coronary syndrome from mobile prehospital care. Sociodemographic and care information was collected from mobile pre-hospital care. During hospitalization, clinical characteristics of admission and care were collected.The association between qualitative variables was performed using the chi-square test or Fisher's Exact test. Regarding the numerical variables, normality was verified using the Kolmogorov-Smirnov test followed by the non-parametric Mann-Whitney test. Results: The incidence of death was found in 8.4% of the 84 participants included. Most of the victims were: male (66.7%), elderly (60.7%), brown (88.1%), treated in the afternoon (38.1%), with presumed critical severity (92.9%), an advanced health unit was sent (94%) and the origin of the call that resulted in death was outside the home (78.6%). Regarding the clinical characteristics of hospital admission, most presented: typical chest pain (86.9%), risk factor for cardiovascular disease present (85.7%), the most common clinical diagnosis was ST-segment elevation infarction (60.7%), and alert (83.3%). Regarding hospital care, most received oxygen supplementation (84.5%), were admitted to the emergency room (81%), underwent percutaneous coronary intervention (67.9%) and echocardiogram (79.8%). The following were risk factors for death (p<0.05): atypical pain, clinical diagnosis of post-cardiorespiratory arrest, level of consciousness on the ADL scale, presence of pain or unconsciousness, received oxygen supplementation, clinical treatment, absence of echocardiogram, left ventricular ejection fraction, oxygen saturation, and heart and respiratory rate. Conclusion: The incidence of death was 8.4% and clinical and in-hospital care risk factors were found with the occurrence of death, which emphasizes the importance of factors related to death in patients with acute coronary syndrome to optimize clinical outcomes and reduce mortality.

DOI: https://doi.org/10.56238/sevened2025.011-019