A retrospective cohort of 234 high-Killip-class STEMI patients receiving PCI at Surat Thani Hospital had 18.8% in-hospital mortality. Anaemia, low mean arterial pressure, more than two vasopressors and multivessel PCI were associated with death. Pre-reperfusion intubation was associated with lower risk, but retrospective data cannot establish a protective effect.
Key findings
- Among 234 patients, 18.8% died. Associations were haemoglobin
Why this matters globally
STEMI with pulmonary oedema or cardiogenic shock remains highly lethal despite reperfusion. Regional-hospital risk models may support team, device and referral planning, but require external discrimination and calibration.
Thai researcher contribution
Surat Thani Hospital and Siriraj Hospital, Mahidol University generated evidence from critically ill patients in a southern Thai referral system, complementing highly selected trial populations.
Limitations to consider
This single-centre retrospective cohort had roughly 44 deaths, limiting events per predictor and yielding unstable odds ratios. Vasopressors, intubation and multivessel PCI were driven by severity and clinician decisions, creating confounding by indication. No external validation or calibration was reported, and treatment-associated ORs are not treatment effects.