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

Sofia Gerward, Patrik Tydén, Ole Hansen, Gunnar Engström, Lars Janzon, Bo Hedblad

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17 Citations (SciVal)

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.
Original languageEnglish
Pages (from-to)164-172
JournalJournal of Internal Medicine
Volume259
Issue number2
DOIs
Publication statusPublished - 2006

Bibliographical note

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)

Subject classification (UKÄ)

  • Clinical Medicine
  • Cardiac and Cardiovascular Systems

Keywords

  • myocardial infarction
  • epidemiology
  • socio-economic factors
  • survival
  • urban population

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