Acute myocardial infarction population incidence and in-hospital management factors associated to 28-day case-fatality in the 65 year and older

被引：19

作者：

Marrugat J. ^{[1
,2
,4
]}

Sala J. ^{[3
]}

Manresa J.M. ^{[1
]}

Gill M. ^{[1
]}

Elosua R. ^{[1
]}

Pérez G. ^{[1
]}

Albert X. ^{[3
]}

Pena A. ^{[1
]}

Masiá R. ^{[3
]}

机构：

[1] Lipids and Cardiovasc. Epidemiol. U., Inst. Munic. d'Investigacio Medica, Barcelona

[2] Universitat Autonoma de Barcelona, Hosp. Univ. Girona Dr. Josep Trueta, Gerona

[3] Servei de Cardiologia, Hosp. Univ. Girona Dr. Josep Trueta, Gerona

[4] Lipids and Cardiovasc. Epid. Res. U., Inst. Munic. d'Investigacio Medica, 08003 Barcelona

来源：

European Journal of Epidemiology | 2004年 / 19卷 / 3期

关键词：

Case-fatality; Coronary disease; Elderly; Incidence; Mortality; Myocardial infarction;

D O I：

10.1023/B:EJEP.0000020446.57845.b0

中图分类号：

学科分类号：

摘要：

Background and objectives: The myocardial infarction (MI) incidence rate, prognosis and hospitalisation rate in the population 65 and over are rarely studied. We sought to determine MI hospitalisation and incidence rates, and 28-day case-fatality, in the 65 year and older population, and to analyse whether their management and prognosis differed from that of younger patients. Methods: All residents in Gerona (Spain) older than 24 years with suspected fatal or non-fatal MI were investigated and included in a population registry. Results: MI mortality, incidence, and case-fatality dramatically increased with age after 64. Smoking, thrombolysis, antiplatelet and betablocker drug use, coronary angiograms, and coronary revascularisation decreased with age. The risk of death of patients between 75 and 84 years (OR: 4.15, 95% confidence interval, CI: 1.70-10.15) and between 85 and 94 years (OR: 4.68, 95% CI: 1.62-13.52) was higher than in the 34-64 years age group, independently of any patient characteristic. Conclusions: The magnitude of the impact of MI in the elderly at population and hospital levels is substantially higher than in those younger than 65 years of age. After this age patients receive less treatments and procedures than their younger counterparts.

引用

页码：231 / 237

页数：6

共 31 条

[1]

World Population Prospects the 2002 Revision Population Database, (2003)

[2]

Morbilidad Hospitalaria por Enfermedad Isquémica del Corazón por Sexo. España 1977-1999, (2003)

[3]

Tunstall-Pedoe H., Kuulasma K., Mahonen M., Et al., Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality: 10-Year results from 37 WHO MONICA Project populations, Lancet, 353, pp. 1547-1557, (1999)

[4]

Mc Govern P.G., Pankow J.S., Sharar E., Et al., Recent trends in acute coronary heart disease-mortality, morbidity, medical care, and risk factors, N Engl J Med, 334, pp. 884-890, (1996)

[5]

Gurwitz J.H., Col N.F., Avron J., The exclusion of the elderly and women from clinical trials in acute myocardial infarction, JAMA, 268, pp. 1417-1422, (1992)

[6]

Perez G., Pena A., Sala J., Roset P.N., Et al., Acute myocardial infarction case fatality, incidence and mortality rates in a population registry in Gerona, Spain, 1990-1992, Int J Epidemiol, 27, pp. 599-604, (1998)

[7]

Chambless L., Keil U., Dobson A., Et al., Population versus clinical view of case fatality from acute coronary heart disease. Results form the WHO-MONICA Project 1985-1990, Circulation, 96, pp. 3849-3859, (1997)

[8]

Murray C.L., Lopez A., Alternative projections of mortality and disability by cause 1990-2020: Global burden of disease study, Lancet, 349, pp. 1498-1504, (1997)

[9]

Thieman D.R., Coresh J., Oetgen W.J., Et al., The association between hospital volume and survival after acute myocardial infarction in elderly patients, N Engl J Med, 340, pp. 1640-1648, (1999)

[10]

Bueno H., Lopez-Palop R., Bermejo J., Et al., In-hospital outcome of elderly patients with acute inferior myocardial infarction and right ventricular involvement, Circulation, 96, pp. 436-441, (1997)

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