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Income and short-term case fatality after myocardial infarction in the whole middle-aged population of Malmo, Sweden.

Rosvall, Maria LU ; Gerward, Sofia LU ; Engström, Gunnar LU and Hedblad, Bo LU (2008) In European Journal of Public Health 18(5). p.533-538
Abstract
BACKGROUND: There are no previous studies investigating when and where those who die pre-hospitally after an AMI paid their last visit to medical care. Methods and RESULTS: Incidence of AMI, pre-hospital and 28-day case fatality rates were monitored over 13 years of follow-up, in relation to sex-specific quartiles of annual income in all inhabitants aged 40-64 years in Malmö, Sweden. Both incidence and short-term case fatality were inversely related to income. In all, 60-70% of all deaths within 28 days after the AMI were pre-hospital deaths. As compared with the lowest income group, the highest income group had lower odds of pre-hospital death with an age- and time-to-event-adjusted odds ratio of 0.5 (95% CI 0.4-0.8) for men and 0.3 (95%... (More)
BACKGROUND: There are no previous studies investigating when and where those who die pre-hospitally after an AMI paid their last visit to medical care. Methods and RESULTS: Incidence of AMI, pre-hospital and 28-day case fatality rates were monitored over 13 years of follow-up, in relation to sex-specific quartiles of annual income in all inhabitants aged 40-64 years in Malmö, Sweden. Both incidence and short-term case fatality were inversely related to income. In all, 60-70% of all deaths within 28 days after the AMI were pre-hospital deaths. As compared with the lowest income group, the highest income group had lower odds of pre-hospital death with an age- and time-to-event-adjusted odds ratio of 0.5 (95% CI 0.4-0.8) for men and 0.3 (95% CI 0.1-0.6) for women. On the other hand, while 72% of those in the lowest two income groups had paid a visit to the medical services during the three months before death, only 59% had done so in the two highest income groups (P < 0.05). CONCLUSIONS: Poor socioeconomic circumstances increase the risk of pre-hospital death after an AMI. Of the pre-hospital deaths, the proportion who had visited the medical services during the 3 months preceding their AMI was higher among those from lower income groups. However, many of those suffering a pre-hospital death had visited clinics that normally do not treat coronary symptoms. If more patients were identified at an earlier stage this might increase the number of patients reaching hospital alive. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Public Health
volume
18
issue
5
pages
533 - 538
publisher
Oxford University Press
external identifiers
  • wos:000259583400020
  • pmid:18621776
  • scopus:52949083886
ISSN
1101-1262
DOI
10.1093/eurpub/ckn059
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Cardio-vascular Epidemiology (013241610), Emergency medicine/Medicine/Surgery (013240200), Social Epidemiology (013241850)
id
210f853a-d2ae-4216-86f2-eda8a4ed2861 (old id 1181248)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18621776?dopt=Abstract
date added to LUP
2016-04-01 11:47:08
date last changed
2022-01-26 18:13:26
@article{210f853a-d2ae-4216-86f2-eda8a4ed2861,
  abstract     = {{BACKGROUND: There are no previous studies investigating when and where those who die pre-hospitally after an AMI paid their last visit to medical care. Methods and RESULTS: Incidence of AMI, pre-hospital and 28-day case fatality rates were monitored over 13 years of follow-up, in relation to sex-specific quartiles of annual income in all inhabitants aged 40-64 years in Malmö, Sweden. Both incidence and short-term case fatality were inversely related to income. In all, 60-70% of all deaths within 28 days after the AMI were pre-hospital deaths. As compared with the lowest income group, the highest income group had lower odds of pre-hospital death with an age- and time-to-event-adjusted odds ratio of 0.5 (95% CI 0.4-0.8) for men and 0.3 (95% CI 0.1-0.6) for women. On the other hand, while 72% of those in the lowest two income groups had paid a visit to the medical services during the three months before death, only 59% had done so in the two highest income groups (P &lt; 0.05). CONCLUSIONS: Poor socioeconomic circumstances increase the risk of pre-hospital death after an AMI. Of the pre-hospital deaths, the proportion who had visited the medical services during the 3 months preceding their AMI was higher among those from lower income groups. However, many of those suffering a pre-hospital death had visited clinics that normally do not treat coronary symptoms. If more patients were identified at an earlier stage this might increase the number of patients reaching hospital alive.}},
  author       = {{Rosvall, Maria and Gerward, Sofia and Engström, Gunnar and Hedblad, Bo}},
  issn         = {{1101-1262}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{533--538}},
  publisher    = {{Oxford University Press}},
  series       = {{European Journal of Public Health}},
  title        = {{Income and short-term case fatality after myocardial infarction in the whole middle-aged population of Malmo, Sweden.}},
  url          = {{http://dx.doi.org/10.1093/eurpub/ckn059}},
  doi          = {{10.1093/eurpub/ckn059}},
  volume       = {{18}},
  year         = {{2008}},
}