Razlike u terapiji pri otpustu iz bolnice između ženskih i muških mladih bolesnika s akutnim koronarnim sindromom

master's thesis

• Title (english): Differences in hospital discharge therapy between female and male young patients with acute coronary syndrome
• Author: Nikolina Maglić
• Mentor: Maja Čikeš (mentor)
• Committee member: Boško Skorić (predsjednik povjerenstva)
• Committee member: Martina Lovrić Benčić (član povjerenstva)
• Committee member: Maja Čikeš (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Incidencija akutnog koronarnog sindroma (infarkta miokarda ili nestabilne angine pektoris) veća je u starijih bolesnika, ali može biti posebno razorna za mlade bolesnike, kod kojih je ova bolest slabije istražena. Temeljem bolničke dokumentacije iz razdoblja 1.1.2012. – 1.1.2020., utvrđena je skupina od 361 ispitanika prosječne dobi 44 ± 6 godina, od kojih je 65.6% imalo STEMI, 25.6% NSTEMI, te 8.8% nestabilnu anginu. Prikupljeni su podaci o rizičnim čimbenicima za razvoj AKS, pojedinostima vezanim uz prijem, pojedinostima nalaza koronarografije i PCI, duljini trajanja hospitalizacije, te farmakoterapiji pri otpustu, odnosno prilikom premještaja u matičnu ustanovu. Provedena je usporedba spolnih razlika u terapiji pri otpustu, odnosno pri premještaju. Uočena je statistički značajna (p = 0.003) razlika između spolova u propisivanju lijekova iz skupine ACE inhibitora u skupini otpuštenih bolesnika. Uočene su i statistički značajne razlike u propisivanju benzodiazepina. Napravljena je multipla Poissonova regresijska analiza prediktora duljine hospitalizacije, koja je pokazala statistički značajan rezultat utjecaja dislipidemije, zahvaćenosti koronarnih arterija, vrijednosti HDL kolesterola i drugih čimbenika na duljinu hospitalizacije. Statistički značajna razlika između muškog i ženskog spola u propisivanju lijekova iz skupine ACE inhibitora u skupini otpuštenih bolesnika, kao i u skupini benzodiazepina u skupini premještenih bolesnika zabrinjavajuća je i predstavlja potencijalan rizik lošijih ishoda mladih žena.

Abstract (english)

Although the incidence of acute coronary syndrome (myocardial infarction or unstable angina pectoris) is higher in older patients, it can be particularly devastating for the young patients, among which this disease is less researched. Based on hospital documentation from 01/01/2012 to 01/01/2020, a group of 361 patients with a mean age of 44 ± 6 years, 65.6% of which had STEMI, 25.6% NSTEMI and 8.8% unstable angina was described. Data were collected on risk factors for acute coronary syndrome, details regarding admission, coronary angiography and PCI findings, length of hospital stay and pharmacotherapy upon hospital discharge or upon transfer to their primary hospital. The hospital discharge or transfer therapy between genders were compared. A statistically significant difference (p = 0.003) was found regarding discharge therapy in terms of ACE inhibitors. Furthermore, statistically significant differences were found for benzodiazepine therapy. A multiple Poisson's regression analysis was performed on the predictors of the length of hospitalization, which yielded a statistically significant result for dyslipidaemia, stage of coronary disease and HDL cholesterol, among others. This statistically significant difference in discharge therapy in terms of both ACE inhibitors and benzodiazepines is worrisome and represents a potential risk of poor patient outcomes regarding young women.

• Keywords: akutni koronarni sindrom; infarkt miokarda; mladi; terapija; spol
• Keywords (english): acute coronary syndrome; myocardial infarction; young; therapy; gender
• Language: croatian
• URN:NBN: urn:nbn:hr:105:807311
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-09 13:23:59