scholarly journals Gender Differences in In-Hospital Mortality Rates among Hispanic Patients with Acute Myocardial Infarction

2017 ◽  
Vol 4 (r) ◽  
Author(s):  
Nawaf Ebrahim Al-Jeraisy ◽  
Abdullah M Al-Sultan ◽  
Sami A Aldaham
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Gender Differences ◽  
Hospital Mortality ◽  
Mortality Rates ◽  
Hispanic Patients

scholarly journals Gender Differences in In-Hospital Mortality Rates among Hispanic Patients with Acute Myocardial Infarction

2017 ◽  
Vol 4 (r) ◽  
Author(s):  
Nawaf Ebrahim Al-Jeraisy ◽  
Abdullah M. Al-Sultan ◽  
Sami A. Aldaham
Keyword(s):  
United States ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
The United States ◽  
Mortality Rates ◽  
Hospital Death ◽  
P Value ◽  
Factors Associated ◽  
Hispanic Patients

Acute myocardial infarction (AMI) is a leading cause of death in the United States with over three million cases per year. Since the mid-1970s, the total number of deaths related to AMI in the United States has not declined. Studies suggest that women with AMI have worse outcomes compared to men. However, there is limited information regarding this topic among Hispanics. This study was a secondary analysis of the Puerto Rican Heart Attack Study, which reviewed the records of Hispanic patients of Puerto Rico hospitalized for AMI at 21 academic and/or non-teaching hospitals in 2007, 2009 and 2011. This study set examined the differences in in-hospital mortality rates between genders. A p-value of 0.2 was used to select possible confounders and the chi-square test was used to examine associations between categorical variables. Factors associated with in-hospital mortality rates were identified using logistic regression. Collinearity was assessed using Pearson correlation coefficients. The 95% confidence interval and a p-value of 0.05 were used to determine statistical significance of odds ratios. Analysis was restricted to patients with ICD-9-CM code 410-414 who are above 18 (n = 2265). In our sample, there were more men than women (1291 versus 974, respectively). Men were younger and smoked more compared to women. Compared to men, women were older and suffered more comorbidities, such as stroke and congestive heart failure (CHF). Women had higher rates of in-hospital mortality compared to men (OR = 1.4, p = 0.040). Factors associated with higher rates of in-hospital mortality included age and CHF (p<0.001). Patients with CHF showed higher rates of in-hospital deaths compared to patients who did not have CHF (OR = 1.6, p = 0.026). Patients over the age of 86 showed higher odds of in-hospital death compared to younger patients (OR = 10.5, p <0.001) Significant disparities existed by gender in this sample of Hispanic AMI patients, with women showing higher in-hospital mortality compared to men. Women over 50 should perform regular checkups and discuss hormone replacement therapy or follow other preventive measures as suggested by their healthcare provider.

scholarly journals Case Definitions for Acute Myocardial Infarction in Administrative Databases and Their Impact on In-Hospital Mortality Rates

2012 ◽  
Vol 48 (1) ◽  
pp. 290-318 ◽  
Author(s):  
Amy Metcalfe ◽  
Annabelle Neudam ◽  
Samantha Forde ◽  
Mingfu Liu ◽  
Saskia Drosler ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Mortality Rates ◽  
Administrative Databases ◽  
Case Definitions

Does acute myocardial infarction kill more people on weekends? Analysis of in-hospital mortality rates for weekend admissions in Portugal

2018 ◽  
Vol 23 (2) ◽  
pp. 87-97 ◽  
Author(s):  
Francesca Fiorentino ◽  
Raquel Ascenção ◽  
Nicoletta Rosati
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Care Delivery ◽  
Severity Index ◽  
Mortality Rates ◽  
Primary Diagnosis ◽  
Weekend Effect ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

Objectives To investigate a possible weekend effect in the in-hospital mortality rate for acute myocardial infarction in Portugal, and whether the delay in invasive intervention contributes to this effect. Methods Data from the National 2011–2015 Diagnostic-Related-Group databases were analysed. The focus was on adult patients admitted via the emergency department and with the primary diagnosis of acute myocardial infarction. Patients were grouped according to ST-elevation myocardial infarction and non-ST-elevation myocardial infarction episodes. We employed multivariable logistic regressions to determine the association between weekend admission and in-hospital mortality, controlling for episode complexity (through a severity index and acute comorbidities), demographic characteristics and hospital identifications. The association between the probability of a prompt surgery (within one day) and the day of admission was investigated to explore the possible delay of care delivery for patients admitted during weekends. Results Our results indicate that in-hospital mortality rates were not significantly higher for weekend admissions than for weekday admissions in both ST-elevation myocardial infarction (STEMI) and non-STEMI episodes. This result is robust to the inclusion of a number of potential confounding mechanisms. Patients admitted on weekends had lower probabilities of undergoing invasive cardiac surgery within the day after admission, but delay in care delivery during the weekend was not associated with worse outcomes in terms of in-hospital mortality. Conclusions There is no evidence for the existence of a weekend effect due to admission for acute myocardial infarction in Portugal, in both STEMI and non-STEMI episodes.

scholarly journals Gaps between supply and demand of acute myocardial infarction treatment in Mexico

2020 ◽  
Vol 62 (5, sep-oct) ◽  
pp. 540-549
Author(s):  
Ricardo Pérez-Cuevas ◽  
Saúl Eduardo Contreras-Sánchez ◽  
Svetlana V Doubova ◽  
Sebastián García-Saisó ◽  
Odet Sarabia-González ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Supply And Demand ◽  
Mortality Rates ◽  
Mortality Trends ◽  
Cross Sectional ◽  
Mixed Methods Approach ◽  
Gender And Age ◽  
Survey Results

Objective. To analyze acute myocardial infarction (AMI) admissions and in-hospital mortality rates and evaluate the competence of the Ministry of Health (MOH) hospitals to provide AMI treatment. Materials and methods. We used a mixed-methods approach: 1) Joinpoint analysis of hos­pitalizations and in-hospital mortality trends between 2005 and 2017; 2) a nation-wide cross-sectional MOH hospital survey. Results. AMI hospitalizations are increasing among men and patients aged >60 years; women have higher mortal­ity rates. The survey included 527 hospitals (2nd level =471; 3rd level =56). We identified insufficient competence to diagnose AMI (2nd level 37%, 3rd level 51%), perform pharmacological perfusion (2nd level 8.7%, 3rd level 26.8%), and mechanical reperfusion (2nd level 2.8%, 3rd level 17.9%). Conclusions. There are wide disparities in demand, supply, and health outcomes of AMI in Mexico. It is advisable to build up the competence with gender and age perspectives in order to di­agnose and manage AMI and reduce AMI mortality effectively.

scholarly journals Gender differences in in-hospital mortality and mechanisms of death after the first acute myocardial infarction

2006 ◽  
Vol 26 (6) ◽  
pp. 455-460 ◽  
Author(s):  
Damir Fabijanic ◽  
Viktor Culic ◽  
Ivo Bozic ◽  
Dinko Miric ◽  
Sanda Stojanovic Stipic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Gender Differences ◽  
Hospital Mortality

P5520Evaluation of the impact of the implementation of a pre-hospital ambulance system on acute myocardial infarction mortality in a developing country

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R C P Vieira ◽  
M S Marcolino ◽  
L G Silva-E-Silva ◽  
A O Jorge ◽  
A L Ribeiro
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Seasonal Variation ◽  
Hospital Mortality ◽  
Prehospital Care ◽  
Mortality Rates ◽  
Minas Gerais ◽  
The State ◽  
Main Role ◽  
The Impact

Abstract Background Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide. The effective management of patients with AMI is directly linked to time, and approximately one-half of the deaths attributed to AMI occur from cardiac arrest in the out-of-hospital setting, reinforcing the importance of the prehospital care. Contemporary data remain particularly lacking about the use of prehospital care in the setting of AMI, particularly from the more generalizable perspective of a community-based investigation, as well as information about the hospital outcomes of patients transported by ambulance. Purpose To assess the impact the implementation of a nationwide ambulance service (Serviço de Atendimento Médico de Urgência, SAMU) on AMI mortality and number of hospitalizations, in the state of Minas Gerais, Brazil. Methods Retrospective, ecological study, which assessed data from the Brazilian Universal Health System (SUS), from all 853 municipalities of Minas Gerais, from 2008 to 2016. SAMU implementation dates were obtained from the state government and SAMU local coordinators. Data on the population of each municipality was obtained from Instituto Brasileiro de Geografia e Estatística (IBGE), the Brazilian official demographic institute. Excessive skewness of general and in-hospital mortality rates were smoothed using the Empirical Bayes method The relationship between SAMU care in each municipality and the mortality due to AMI in the general population, in-hospital mortality and number of hospitalizations for AMI was assessed using the Poisson hierarchical model, and the analyzed rates were corrected by the age structure and detrended by seasonal influences. Results AMI mortality rates showed a decreasing tendency throughout the study, on average 2% per year, and seasonal variation, being higher during winter months. Age-corrected AMI in-hospital mortality also showed a decreasing trend, from 13.81% in 2008 to 11.43% in 2016. SAMU implementation was associated with decreased AMI mortality (odds ratio [OR]=0.967, 95% confidence interval [CI] 0.936–0.998) and AMI in-hospital mortality (OR=0.914, 95% CI 0.845–0.986) with no relation with the number of hospitalizations (OR 1.003, 95% CI 0.927–1.083). There was no seasonal variation in the number of AMI hospitalizations. Conclusion SAMU implementation was related to a modest but significant decrease in AMI in-hospital mortality. This finding reinforces the main role of prehospital care in AMI care and reinforces the need for investment in improving the service throughout the country.

Age-Specific Gender Differences in In-Hospital Mortality by Type of Acute Myocardial Infarction

2012 ◽  
Vol 109 (8) ◽  
pp. 1097-1103 ◽  
Author(s):  
Zefeng Zhang ◽  
Jing Fang ◽  
Cathleen Gillespie ◽  
Guijing Wang ◽  
Yuling Hong ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Gender Differences ◽  
Hospital Mortality

Abstract 309: Trends in LVAD Use and Outcomes Among Patients Admitted with Acute Myocardial Infarction

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Jennifer Lewey ◽  
Eric Secemsky ◽  
Charlotta Lindvall
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Mortality Rates ◽  
Left Ventricular ◽  
Mechanical Support ◽  
Icd9 Code ◽  
Baseline Characteristics ◽  
Support Devices ◽  
Over Time

Background: Mortality rates among patients with acute myocardial infarction (AMI) complicated by cardiogenic shock remain high. Implantation of left ventricular assist devices (LVAD) has become increasingly available since the approval of continuous flow devices in 2008 and in severe cases, may be used to prolong survival post AMI. Little is known about how the frequency of LVAD implantation and subsequent outcomes in AMI patients have changed over time. Methods: We used the National Inpatient Sample, a 20% stratified sample of all hospital discharges that uses scaled weights to approximate national estimates. We identified all patients with AMI (ICD9 code 410.1x) and LVAD implantation (ICD9 code 37.66) from 2006 through 2012.The primary outcome was in-hospital mortality. Baseline characteristics were compared over time using the chi-square test for categorical variables. Univariate logistic regression was used to examine the association between baseline characteristics and risk of mortality after LVAD. Results: The number of LVADs implanted for any indication increased from 713 to 2,960 during the study period whereas LVAD use among AMI patients remained stable (Figure). AMI patients who received an LVAD were predominately male and white and the average age was 56.3 years. The number of AMI patients receiving ECMO, Impella, or other short-term mechanical support devices as a bridge to LVAD increased over time whereas IABP use remained stable. Among patient and hospital factors studies, non-white race and later year of implantation were associated with lower mortality after LVAD. Use of other mechanical support devices was associated with higher mortality (OR 2.7, p=0.029). Post-LVAD mortality rates were higher for AMI compared to non-AMI patients but decreased for all patients over time: 57.1% to 21.2% for AMI patients (p <.0001) and 36.8% to 12.8% for patients without AMI, p < .0001). Conclusion: Among patients with AMI, LVAD use remains low and has not increased as has LVAD use for other indications. Although LVAD use in this population was initially associated with higher in-hospital mortality, our analysis suggests a narrowing of this gap. Future studies are needed to determine how long-term survival is affected and which patients are appropriate candidates for LVAD implantation after AMI.

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