Killip-Kimball Classification Validation, Outcomes and Demographics in an Octogenarian Cohort with Acute Coronary Syndrome in a Developing Country: A Third-Level Multicenter 11-Year Experience

Abstract

Introduction: The Killip-Kimball Classification (KC) is used to group patients with acute coronary syndrome (ACS) based on their clinical profile. It has proven to be useful while predicting both short- and long-term mortality. Contemporary data in the elderly population is limited. We sought to analyze trends in outcomes of patients 80 years or older admitted for ACS, by Killip Class. In addition, we assess the validity of the KC in this population. Methodology: A retrospective analysis of patients who underwent a catheterization procedure for ACS was performed. ACS was defined as per AHA guidelines, and included STEMI, non-STEMI and Unstable Angina. We determined factors influencing the KC in which patients present 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 were analyzed. Included were: 86, 9, 23 and 15 patients in KC-I through IV respectively with a mean age of 83. The main comorbidities were hypertension (73%), and diabetes (43%). In-hospital mortality was 12%, which was different between KC groups (p< 0.01). 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 Killip class have a high mortality rate, as described in younger cohorts. The Killip-Kimball classification remains a reliable prognostic tool, with applicability in octogenarian patients.