David F. Almanza-Hernández, Medicina Crítica y Cuidados Intensivos, Hospital Universitario Fundación Santa Fe; Medicina Crítica y Cuidados Intensivos, Hospital Universitario Mayor-Méderi; Bogotá, Colombia
Julián F. Celis-Guzmán, Medicina Crítica y Cuidados Intensivos, Hospital Universitario Fundación Santa Fe; Medicina Crítica y Cuidados Intensivos, Hospital Universitario Mayor-Méderi; Bogotá, Colombia
Andrés F. Buitrago-Sandoval, Medicina Crítica y Cuidados Intensivos, Hospital Universitario Fundación Santa Fe;; Departamento de Cardiología, Hospital Universitario Fundación Santa Fe; Bogotá, Colombia
David R. Rodríguez-Lima, Medicina Crítica y Cuidados Intensivos, Hospital Universitario Mayor-Méderi; Grupo de Investigación Clínica, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario; Bogotá, Colombia.
Introduction: Killip-Kimball (KK) scale enables rapid clinical stratification upon admission of patients with ST-elevation acute myocardial infarction (STEMI). Objective: to evaluate 28-day mortality based on KK admission scores in patients with STEMI. Methods: this was an observational, analytical study of a retrospective cohort that included all adult patients diagnosed with STEMI treated in a Hospital Universitario between January 2010 and December 2020. It was evaluated the classification of KK at emergency department admission for stratifying patients into risk groups. Kaplan-Meier (KM) curves and Cox proportional hazard models were performed to determine the association between KK classification and mortality. Results: 413 patients were included, a median age of 63 years (interquartile range 55-74). Overall, 28-day mortality was 7.0% (n = 29). 79% (n = 327) had KK I, 7.9% (n = 33) KK II, 5.4% (n = 22) KK III, and 7.7% (n = 31) KK IV, with 28-day mortalities of 2.8% (n = 9), 12.2% (n = 4), 18.2% (n = 4), and 38.8% (n = 12), respectively (log-rank test p < 0.001). Adjusted hazard ratios (HR) for 28-day mortality compared to KK I were 4.0 (95% CI: 1.19-13.6; p = 0.026) for KK II, 4.7 (95% CI: 1.34-16.8; p = 0.016) KK III, and 9.9 (95% CI: 3.50-27.8; p < 0.001) KK IV. Conclusions: KK classification upon admission allows for the prognostication of 28-day mortality in patients with STEMI.
Keywords: Acute myocardial infarction. Killip-Kimball. Mortality. Prognosis.
