[Automatic processing of clinical information related to 2334 myocardial infarcts consecutively hospitalized at a coronary care unit].
OBJECTIVE
Brief description of a clinical information system and its application to 2334 cases of acute myocardial infarction.


METHODS
To evaluate the influence on intra-hospital prognosis of 22 clinical characteristics observed in patients on the acute phase of myocardial infarction admitted to a coronary care unit.


METHODS
Coronary care unit.


METHODS
2334 cases of myocardial infarction admitted sequentially to a coronary care unit.


METHODS
A locally developed computerized information system was used. Software was organized in a modular way in order to turn available simplicity, flexibility and expandibility which are requisites of an automatic information system operating in a coronary unit. Following characteristics were evaluated: age and sex; previous myocardial infarction, angina, hypertension, diabetes, tabagism and hyperlipidemia; electrocardiographic localization of the infarction; ventricular dysfunction as evaluated by Killip classes; supraventricular and ventricular dysrhythmias; auriculo ventricular and intraventricular blocks; epistenocardic pericarditis; intra-hospital extension of the infarction; transient episode of hypertension and post-infarction angina. Statistical association between these characteristics and intra-hospital mortality was evaluated. Statistical significance was considered with a p less than 0.05.


RESULTS
Statistical significant differences were found between surviving and non-surviving patients in the following characteristics: age and sex; previous history of myocardial infarction, angina and diabetes; Killip classes distribution; electrocardiographic localization of the infarction; intra-hospital extension of the infarction; auriculoventricular block, left and right bundle branch block; supraventricular and ventricular dysrhythmias. Patients with a previous history of tabagism and hyperlipidemia had a lesser mortality and were younger than the patients without these characteristics. Patients with transient episodes of hypertension and epistenocardic pericarditis had a lesser hospital mortality.


CONCLUSIONS
Local development of a computerized information system turned available clinical information of 2334 patients sequentially admitted to a coronary care unit. A worse intra-hospital prognosis was present in the following groups of patients: older patients and females; patients with a previous history of infarction, angina and diabetes; anterior myocardial infarction, left ventricular dysfunction as evaluated by Killip classes, ventricular and supraventricular dysrhythmias, auriculoventricular and intraventricular blocks, transient episodes of hypertension and extension of the infarction. Patients with a previous history of tabagism and hyperlipidemia had a lesser mortality; however, there patients were younger than other. Patients with transient episodes of hypertension on first hours of infarction and those who had epistenocardic pericarditis had a lesser mortality.
Santos
A L
AL
Azevedo
J
J
Melo
M
M
Covas
M
M
da Silva
C A
CA
Ribeiro
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002300:Cardiac Care Facilities; D001330:Electronic Data Processing; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*
Tratamento automático da informação clínica referente a 2334 enfartes do miocárdio consecutivamente internados numa unidade coronária.