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Survival rate 28 days after hospital admission with first myocardial infarction. Inverse relationship with socio-economic circumstances.

Gerward, Sofia LU ; Tydén, Patrik LU ; Hansen, Ole LU ; Engström, Gunnar LU ; Janzon, Lars LU and Hedblad, Bo LU (2006) In Journal of Internal Medicine 259(2). p.164-172
Abstract
Objective. To study to what extent geographical differences of the mortality from ischaemic heart disease (IHD) can be accounted for by the 28-day case fatality rate (CFR) following first hospital admittance for acute myocardial infarction (MI) and whether the geographical pattern of survival has any relationship with socio-economic circumstances. Design. Register-based surveillance study. Setting. Seventeen residential areas in Malmo, Sweden. Subjects. All 5533 patients were admitted during 1986-1995 for a first acute MI at Malmo University Hospital. Main outcome measures. CFR is based on record linkage with national registers. Area-specific cardiovascular and socio-economic scores (SES) are based on previous cross-sectional studies.... (More)
Objective. To study to what extent geographical differences of the mortality from ischaemic heart disease (IHD) can be accounted for by the 28-day case fatality rate (CFR) following first hospital admittance for acute myocardial infarction (MI) and whether the geographical pattern of survival has any relationship with socio-economic circumstances. Design. Register-based surveillance study. Setting. Seventeen residential areas in Malmo, Sweden. Subjects. All 5533 patients were admitted during 1986-1995 for a first acute MI at Malmo University Hospital. Main outcome measures. CFR is based on record linkage with national registers. Area-specific cardiovascular and socio-economic scores (SES) are based on previous cross-sectional studies. Results. In patients below 75 years of age, differences of the 28-day CFR accounted for 20-30% of the geographical variance in mortality from IHD. No corresponding association was found in older age groups. Patients from areas with low SES had the highest CFR, 23.8%. The odds ratios of fatal outcome for patients from areas with median and low SES (versus high SES) were 1.23 (95% CI: 1.01-1.50) and 1.25 (95% CI: 1.03-1.52), respectively (P for trend: 0.060). The strongest correlation was observed in men below 75 years of age (P for trend: 0.007). During the study period there was an improvement of the survival rate for patients from high and medium SES areas but no corresponding change for patients coming from areas having a low SES. Conclusions. In patients below 75 years, geographical differences of the mortality from IHD were related to differences of the 28-day CFR following hospital admittance for a first MI. Rates of survival were inversely related to socio-economic circumstances in the patient's residential area. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
myocardial infarction, epidemiology, socio-economic factors, survival, urban population
in
Journal of Internal Medicine
volume
259
issue
2
pages
164 - 172
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • pmid:16420545
  • wos:000234697500004
  • scopus:33644855501
ISSN
1365-2796
DOI
10.1111/j.1365-2796.2005.01594.x
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)
id
7bf57ac6-0484-46ef-abf7-c60e3c2f8fbc (old id 150270)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16420545&dopt=Abstract
date added to LUP
2016-04-01 16:17:47
date last changed
2020-01-12 19:13:54
@article{7bf57ac6-0484-46ef-abf7-c60e3c2f8fbc,
  abstract     = {Objective. To study to what extent geographical differences of the mortality from ischaemic heart disease (IHD) can be accounted for by the 28-day case fatality rate (CFR) following first hospital admittance for acute myocardial infarction (MI) and whether the geographical pattern of survival has any relationship with socio-economic circumstances. Design. Register-based surveillance study. Setting. Seventeen residential areas in Malmo, Sweden. Subjects. All 5533 patients were admitted during 1986-1995 for a first acute MI at Malmo University Hospital. Main outcome measures. CFR is based on record linkage with national registers. Area-specific cardiovascular and socio-economic scores (SES) are based on previous cross-sectional studies. Results. In patients below 75 years of age, differences of the 28-day CFR accounted for 20-30% of the geographical variance in mortality from IHD. No corresponding association was found in older age groups. Patients from areas with low SES had the highest CFR, 23.8%. The odds ratios of fatal outcome for patients from areas with median and low SES (versus high SES) were 1.23 (95% CI: 1.01-1.50) and 1.25 (95% CI: 1.03-1.52), respectively (P for trend: 0.060). The strongest correlation was observed in men below 75 years of age (P for trend: 0.007). During the study period there was an improvement of the survival rate for patients from high and medium SES areas but no corresponding change for patients coming from areas having a low SES. Conclusions. In patients below 75 years, geographical differences of the mortality from IHD were related to differences of the 28-day CFR following hospital admittance for a first MI. Rates of survival were inversely related to socio-economic circumstances in the patient's residential area.},
  author       = {Gerward, Sofia and Tydén, Patrik and Hansen, Ole and Engström, Gunnar and Janzon, Lars and Hedblad, Bo},
  issn         = {1365-2796},
  language     = {eng},
  number       = {2},
  pages        = {164--172},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Journal of Internal Medicine},
  title        = {Survival rate 28 days after hospital admission with first myocardial infarction. Inverse relationship with socio-economic circumstances.},
  url          = {http://dx.doi.org/10.1111/j.1365-2796.2005.01594.x},
  doi          = {10.1111/j.1365-2796.2005.01594.x},
  volume       = {259},
  year         = {2006},
}