Killip-Kimball classification in octogenarians with acute coronary syndrome: an 11-year experience Clasificación de Killip-Kimball en octogenarios con síndrome coronario agudo: 11 años de experiencia
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© 2021 Instituto Nacional de Cardiología Ignacio Chávez.Objective: The objective of the study is to validate the use of the Killip-Kimball classification (KC) as a predictor of outcomes in an octogenarian cohort with acute coronary syndrome. Methods: A retrospective analysis of patients who underwent a catheterization procedure for acute coronary syndrome (ACS) was performed. ACS was defined as per the American Heart Association guidelines, and included ST-elevation myocardial infarction (STEMI), non-STEMI and Unstable Angina. We determined factors associated with the KC upon admission to the emergency room. Likewise, we compared in-hospital mortality, length of stay, and other outcomes dividing the patients by KC. Results: A total of 133 patients with a mean age of 83 years were analyzed and assigned a KC from 1 to 4 according to clinical presentation. Each group included 86, 9, 23, and 15 patients, respectively. In-hospital mortality was 12%, 5% in KC-I, 11% in KC-II, 22% in KC-III, and 40% in KC-IV with a significant difference between classes (p = 0.002). In addition, we found higher KC groups to be associated with acute kidney injury during the hospitalization (p < 0.01). Conclusion: Despite a strong reduction in mortality for elderly patients with ACS in recent decades, patients presenting with ACS and higher KC have a high mortality rate, as described in younger cohorts. KC remains a reliable prognostic tool, with applicability in octogenarian patients.
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