A Study of the Causes of In-Hospital Mortality in Patients with Acute Myocardial Infarction Complicated by Gastrointestinal Haemorrhage

Objective: To analyze the risk factors for death during hospitalization in patients with acute myocardial infarction (AMI) complicated by gastrointestinal bleeding (GIB). Methods: 260 patients with AMI complicated by GIB who were admitted to the cardiology department of a hospital from January 2022 to December 2023 were retrospectively analyzed. 27 patients who died during hospitalization were designated as the control group and the 233 patients who survived as the observation group. Baseline data and clinical indexes of patients in the two groups were compared, and multifactorial logistic regression was applied to analyze the risk factors for death during hospitalization in patients with AMI complicated by GIB. Results: Univariate analysis showed that the control group had higher proportions of patients with Killip classification III to IV on admission, new arrhythmias, and mechanical complications, as well as higher heart rates, white blood cell counts, urea nitrogen, and creatinine levels. The proportion of patients who received transfusion therapy during hospitalization was also higher in the control group. Conversely, the control group had lower systolic and left ventricular ejection fraction rates compared to the observation group, with statistically significant differences (P < 0.05). Multifactorial logistic regression analysis revealed that new-onset arrhythmia (OR = 2.724, 95% CI 1.289–5.759), heart rate > 100 beats/min (OR = 3.824, 95% CI 1.472–9.927), left ventricular ejection fraction < 50% (OR = 1.884, 95% CI 0.893–3.968), BUN level (OR = 1.029, 95% CI 1.007–1.052), and blood transfusion (OR = 3.774, 95% CI 1.124–6.345) were independently associated with an increased risk of death during hospitalization in patients with AMI complicated by GIB. Conclusions: New arrhythmia, heart rate > 100 beats/min, left ventricular ejection fraction < 50%, elevated BUN levels, and blood transfusion are risk factors for death during hospitalization in patients with AMI complicated by GIB.