Development of a predictive model for in-hospital death in acute myocardial infarction combined with cardiogenic shock

Li Jinbin; Quan Meiling; Li Xiaoxue

doi:10.3969/j.issn.1674-4055.2024.03.07

Abstract：Objective To analyze the factors influencing the occurrence of in-hospital death in acute myocardial infarction combined with cardiogenic shock(AMICS)and to develop a predictive model.Methods A total of 251 AMICS patients admitted to our hospital from January 2020 to June 2022 were selected and divided into a death group and a survival group based on in-hospital survival outcomes.The clinical data of AMICS patients were collected,the factors influencing in-hospital mortality in AMICS patients were analyzed using univariate and multi-factor logistic regression and the predictive model was constructed.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of the in-hospital mortality prediction model for AMICS patients.Results In-hospital mortality in 251 AMICS patients was 38.65%(97/251).Univariate analysis showed that the proportion of age≥60 years and the levels of lactate(Lac),cardiac troponin I,B-type natriuretic peptide(BNP),D-dimer,blood creatinine and blood urea nitrogen(BUN)were higher in the death group than in the survival group,and systolic blood pressure(SBP)and left ventricular ejection fraction(LVEF)were lower than in the survival group(P<0.05).Multi-factor logistic regression analysis showed that age≥60 years and elevated Lac,BNP,D-dimer and BUN were independent risk factors for in-hospital mortality in AMICS patients,and elevated SBP and LVEF were independent protective factors(P<0.05).Predictive model equation for in-hospital mortality in AMICS patients:y=1.246-0.757×age-0.053×SBP-0.073×LVEF+0.565×Lac+0.005×BNP+0.554×D-dimer+0.179×BUN.ROC curve analysis showed that the area under the curve of this predictive model for predicting in-hospital mortality in AMICS patients was 0.905,with a sensitivity and specificity of 79.38%and 88.96%,respectively.ROC curve analysis showed that the area under the curve of this predictive model for predicting in-hospital mortality in AMICS patients was 0.905,with a sensitivity and specificity of 79.38%and 88.96%,respectively.Conclusion The predictive model of in-hospital mortality in AMICS patients constructed based on age,SBP,LVEF,Lac,BNP,D-dimer and BUN has a high predictive value for in-hospital mortality in AMICS patients.