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Geographical pattern of female deaths from myocardial infarction in an urban population: fatal outcome out-of-hospital related to socio-economic deprivation

Tydén, Patrik LU ; Engström, Gunnar LU ; Hansen, O; Hedblad, Bo LU and Janzon, Lars LU (2001) In Journal of Internal Medicine1989-01-01+01:00 250(3). p.201-207
Abstract
OBJECTIVE: This study of myocardial infarction (MI) amongst urban women has sought to assess whether there are differences in fatal outcome, in-hospital respectively out-of-hospital, between residential areas defined in terms of socio-economic circumstances. DESIGN: Register-based surveillance study 1986-95. SETTING: Seventeen residential areas in the city of Malmo, Sweden. SUBJECTS: Women 20-74 years of age. MAIN OUTCOME MEASURES: Differences in fatal outcome, in-hospital respectively out-of-hospital, between residential areas were expressed in terms of age-adjusted odds ratios (ORs), calculated by means of logistic regression. Socio-economic circumstances in the areas were expressed in terms of a composite score. RESULTS: Between... (More)
OBJECTIVE: This study of myocardial infarction (MI) amongst urban women has sought to assess whether there are differences in fatal outcome, in-hospital respectively out-of-hospital, between residential areas defined in terms of socio-economic circumstances. DESIGN: Register-based surveillance study 1986-95. SETTING: Seventeen residential areas in the city of Malmo, Sweden. SUBJECTS: Women 20-74 years of age. MAIN OUTCOME MEASURES: Differences in fatal outcome, in-hospital respectively out-of-hospital, between residential areas were expressed in terms of age-adjusted odds ratios (ORs), calculated by means of logistic regression. Socio-economic circumstances in the areas were expressed in terms of a composite score. RESULTS: Between residential areas there were marked and statistically significant differences in incidence (range 124-328/10(5), P < 0.001, d.f.=16) and mortality (range 38-132/10(5), P < 0.005, d.f.=16). Area rates of mortality covaried with incidence (r=0.85, P < 0.001) and with odds ratios of fatal outcome out-of-hospital (r=0.52, P=0.031) but not in-hospital. The odds ratios of fatal outcome out-of-hospital decreased in a statistically significant stepwise fashion from areas in the lowest socio-economic quintile (reference) to areas in the highest socio-economic quintile (OR: 0.67, 95% CI: 0.48-0.94). There was no corresponding association with the odds ratios of fatal outcome in-hospital. CONCLUSIONS: The high rate of mortality from MI amongst women in areas with deprived socio-economic circumstances was related to deaths occurring out-of-hospital. In order to assess the preventive potential there is a need for further studies that may clarify to what extent the association with socio-economic circumstances can be explained by other factors and conditions known to influence the probability of survival. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
fatal outcome, female, incidence, mortality, myocardial infarction, socio-economic factors
in
Journal of Internal Medicine1989-01-01+01:00
volume
250
issue
3
pages
201 - 207
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • pmid:11555123
  • scopus:0035720472
ISSN
1365-2796
DOI
10.1046/j.1365-2796.2001.00877.x
language
English
LU publication?
yes
id
98600ddd-5c0e-410b-98bc-8bddb6bc9ad8 (old id 1118463)
date added to LUP
2008-07-17 08:23:44
date last changed
2018-06-24 04:42:18
@article{98600ddd-5c0e-410b-98bc-8bddb6bc9ad8,
  abstract     = {OBJECTIVE: This study of myocardial infarction (MI) amongst urban women has sought to assess whether there are differences in fatal outcome, in-hospital respectively out-of-hospital, between residential areas defined in terms of socio-economic circumstances. DESIGN: Register-based surveillance study 1986-95. SETTING: Seventeen residential areas in the city of Malmo, Sweden. SUBJECTS: Women 20-74 years of age. MAIN OUTCOME MEASURES: Differences in fatal outcome, in-hospital respectively out-of-hospital, between residential areas were expressed in terms of age-adjusted odds ratios (ORs), calculated by means of logistic regression. Socio-economic circumstances in the areas were expressed in terms of a composite score. RESULTS: Between residential areas there were marked and statistically significant differences in incidence (range 124-328/10(5), P &lt; 0.001, d.f.=16) and mortality (range 38-132/10(5), P &lt; 0.005, d.f.=16). Area rates of mortality covaried with incidence (r=0.85, P &lt; 0.001) and with odds ratios of fatal outcome out-of-hospital (r=0.52, P=0.031) but not in-hospital. The odds ratios of fatal outcome out-of-hospital decreased in a statistically significant stepwise fashion from areas in the lowest socio-economic quintile (reference) to areas in the highest socio-economic quintile (OR: 0.67, 95% CI: 0.48-0.94). There was no corresponding association with the odds ratios of fatal outcome in-hospital. CONCLUSIONS: The high rate of mortality from MI amongst women in areas with deprived socio-economic circumstances was related to deaths occurring out-of-hospital. In order to assess the preventive potential there is a need for further studies that may clarify to what extent the association with socio-economic circumstances can be explained by other factors and conditions known to influence the probability of survival.},
  author       = {Tydén, Patrik and Engström, Gunnar and Hansen, O and Hedblad, Bo and Janzon, Lars},
  issn         = {1365-2796},
  keyword      = {fatal outcome,female,incidence,mortality,myocardial infarction,socio-economic factors},
  language     = {eng},
  number       = {3},
  pages        = {201--207},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Journal of Internal Medicine1989-01-01+01:00},
  title        = {Geographical pattern of female deaths from myocardial infarction in an urban population: fatal outcome out-of-hospital related to socio-economic deprivation},
  url          = {http://dx.doi.org/10.1046/j.1365-2796.2001.00877.x},
  volume       = {250},
  year         = {2001},
}