BACKGROUND: Admission of patients with acute myocardial infarction (MI) in a medical ward in a tertiary government hospital is unavoidable due to a numerous patients coming from other health care institutions. Discerning the outcome of admissions in the ward and intensive care unit (ICU); and the clinical risk factors leading to more adverse outcomes can provide useful information as to the need for a more aggressive approach in managing these patients.
OBJECTIVE: This study aims to determine outcome of patients with hemodynamically unstable MI admitted at the ward and ICU in a tertiary government hospital in Bacolod City. The profile of patients in accordance to age, sex, smoking, previous MI, presence of co-morbidities (Hypertension, Diabetes Mellitus, and arrhythmia), STEMI or NSTEMI,Killip Classification, and area of admission will be determined including the relationship of these variables to patient outcomes.
METHODOLOGY: A retrospective, correlational research design was utilized in this study. The correlational aspect of the study focused on determining whether a significant relationship exists between patient outcomes and the grouping variables.
RESULT: A total of 54 patients were included in the study. 22 (40.7%) were admitted at the ward and 32 (59.3%) admitted at the ICU. 50% were adults, aged 25-64 years old and 50% were elderly, aged 65 years old and above. Majority (n=29, 53.7%) are males, non-smokers (n=40, 74.1%) with no history of previous MI (94.4%). STEMI comprised 55.6% of cases (n=30) and 64.8% under Killip IV. 63% of patients had Diabetes Mellitus (n=34). 50% were hypertensive. Only 16.7% (n=9) hadarrhythmia and 53.7% (n=29) of patients expired.
CONCLUSION: In atertiary government hospital, not all patients with hemodynamically unstable MI can be admitted at the ICU due to the numerous patients coming from other health care institutions. Patients end up being admitted at the ward. Smoking, history of previous MI and Killip IV classification are risk factors for mortality among patients with hemodynamically unstable MI.
KEYWORDS: hemodynamically unstable myocardial infarction, acute myocardial infarction, tertiary government hospital, Bacolod city.