In-hospital case fatality rates for acute myocardial infarction in Romania

Background: We describe the clinical characteristics, treatments and in-hospital case-fatality rates in an unselected population of patients admitted for acute myocardial infarction. Methods: From January 2000 to June 2007, we tracked consecutive patients who were admitted to 7 tertiary referral and 21 county hospitals in Romania for medical treatment of ST-segment elevation acute myocardial infarction. These patients were enrolled in the Romanian Registry for ST-segment Elevation Myocardial Infarction. For this prospective study, we collected data on demographic characteristics, cardiovascular risk factors, various aspects of treatment for myocardial infarction, and in-hospital death. Results: The 9186 patients in the study group had a mean age of 63.8 years. The median time from onset of symptoms to thrombolysis was 230 (interquartile range 120-510) minutes. Of the 9186 patients, 4986 (54.3%) had hypertension, 1974 (21.5%) had diabetes mellitus, 3545 (38.6%) had lipid disorders and 4653 (50.7%) were smokers. The in-hospital mortality rate was 12.7% (1170 deaths). The study group consisted of 2893 women and 6293 men. The women were older than the men and had higher rates of hypertension and diabetes mellitus but were less likely to be smokers. A smaller proportion of women than men presented within 2 hours after onset of symptoms (23.1% v. 34.4%, p < 0.001). Smaller proportions of women received thrombolytics (40.8% v. 53.5%, p < 0.001), anticoagulants (93.4% v. 95.2%; p = 0.001), antiplatelet agents (88.3% v. 91.2%, p < 0.001) and primary percutaneous coronary interventions (1.5% v. 2.2%, p = 0.030). The risk of in-hospital death was greater for women, even after adjustment for confounders (odds ratio 1.33, 95% confidence interval 1.13-1.56; p < 0.001). Interpretation: The rates of reperfusion therapy for patients with acute myocardial infarction were low, and in-hospital case-fatality rates were high in this study. Excess in-hospital mortality was more pronounced among women

Antibiotic resistance in community-acquired pneumonia. A romanian perspective

Community-acquired pneumonia (CAP) is one of the most common communicable diseases with a high mortality rate worldwide. Treatment is administered empirically based on clinical symptoms and the most commonly incriminated microorganisms in lower respiratory infections responsible for CAP. This study aimed to identify microorganisms responsible for CAP in patients hospitalized in an Emergency Hospital in Bucharest, Romania; to assess the impact of patients’ comorbidities and age on the survival level and to establish the degree of antimicrobial resistance of the most important isolated species. A total of 170 patients diagnosed with CAP from December 2017 through December 2018 were studied. Statistical analyses were performed considering the following data: survival rate, comorbidities, initiated pharmacotherapy, antibiogram results in case of refractory treatments. The overall survival rate was 36% among patients. Cardiovascular disease was incriminated as the highest risk factor. Concerning refractory antibiotic treatment, the microbiological results revealed that the most common bacterial strains detected were Klebsiella sp., Acinetobacter baumanii, S. aureus, E. coli and Pseudomonas, with high multiple antibiotic resistance (MAR) index. The results point out a real concern for patients with refractory CAP due to high antimicrobial resistance to the administered antibiotics in Romania. © 2020, Romanian Society for Pharmaceutical Sciences. All rights reserved