Under-24-hour mortality from acute coronary syndrome in emegrency hospital

Aim. To identify the factors influencing the strategy and tactics of treating patients with acute coronary syndrome; to define the impact of various stages of emergency care in total rate of under-24-hour in-patients mortality. Methods. The retrospective analysis of the in-patients medical charts, ambulance accompanying sheets and autopsy protocols of 303 patients who died during the first 24 hours after admission to the department of cardiology at Municipal Emergency Hospital №1, Kazan from January 1st, 2009 to December 31th, 2011. Results. The level of under-24-hour in-patients mortality in the emergency hospital remains considerably high without a tendency to fall. In economically active group of population male to female mortality ratio exceeds 1,8. Most patients are being brought to the hospital by ambulance crews which are not enough qualified and equipped to care for patients in a critical condition. Only 48.3% of admitted patients get medical aid before admission, although the share of patients admitted in a poor, critical or agonal condition is 89.8%. Conclusion. Decreasing under-24-hour mortality is a multidimensional and multifactorial problem, which demands a complex approach in all stages of providing medical care to be solved.

under-24-hour mortality, myocardial infarction, acute clinical conditions, ambulance, public health management, age groups, social status, pre-admission stage