| Titre : | Mortality after acute myocardial infarction is lower in metropolitan regions than in non-metropolitan regions. (2000) |
| Auteurs : | HUY DINH VU . (.) ; C. D'ESTE ; R.F. HELLER ; Ll-Y LIM ; R.L. O'CONNELL ; Centre for Clinical Epidemiology and Biostatistics. The University of Newcastle. David Maddison Clinical Sciences Building. Royal Newcastle Hospital. Newcastle. AUS |
| Type de document : | Article |
| Dans : | Journal of epidemiology and community health (vol. 54, n° 8, 2000) |
| Pagination : | 590-595 |
| Langues: | Anglais |
| Mots-clés : | Infarctus ; Myocarde ; Mortalité ; Hôpital ; Etude comparée ; Homme ; Australie ; Océanie ; Appareil circulatoire [pathologie] ; Cardiopathie coronaire ; Myocarde [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST DdR0x0Da. Diffusion soumise à autorisation]. Study objectives-To compare inhospital mortality for acute myocardial infarction (AMI) between metropolitan and non-metropolitan hospitals after adjustment for patients'severity ; to examine the role of the use of effective cardiac medications in the possible mortality difference between these types of hospital. Design-Retrospective cohort study. Setting-47 acute public hospitals in metropolitan and non-metropolitan areas of New South Wales, Australia, taking part in the Acute Cardiac Care Project based on medical record review. Patients-1665 patients with principal discharge diagnosis of AMI from February to June 1996. Main results-There was no difference in crude mortality rate (assessed as seven day mortality) between metropolitan and non-metropolitan hospitals (11.0% compared with 10.7% respectively, p=0.893). After adjustment for severity in a logistic regression model, the odds of death in non-metropolitan hospitals was significantly higher than in metropolitan hospitals (odds ratio=1.90 ; 95% CI 1.21,3.23). The addition of the use of effective cardiac medications to the model resulted in the difference between hospital type becoming non-significant (odds ratio=1.09 ; 95% CI 0.57,2.07). Conclusions-Inhospital mortality in non-metropolitan hospitals was higher than that in metropolitan hospitals, after adjustment for patients'severity. This might partly be explained by the difference in use of effective cardiac medications between hospital type. |
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