Age- and Sex-Specific In-Hospital Mortality after Myocardial Infarction in Routine Clinical Practice

Abstract EN

Background.

Literature regarding the influence of age/sex on mortality trends for acute myocardial infarction (AMI) hospitalizations is limited to hospitals participating in voluntary AMI registries.

Objective.

Evaluate the impact of age and sex on in-hospital AMI mortality using a nationally representative hospital sample.

Methods.

Secondary data analysis using AMI hospitalizations identified from the Nationwide-Inpatient-Sample (NIS).

Descriptive and Cox proportional hazards analysis explored mortality trends by age and sex from 1997–2006 while adjusting for the influence of, demographics, co-morbidity, length of hospital stay and hospital characteristics.

Results.

From 1997–2006, in-hospital AMI mortality rates decreased across time in all subgroups (P<.001), except for males aged <55 years.

The greatest decline was observed in females aged <55 years, compared to similarly aged males, mortality outcomes were poorer in 1997-1998 (RR 1.47, 95% CI = 1.30–1.66), when compared with 2005-2006 (RR 1.03, 95% CI = 0.90–1.18), adjusted P value for trend demonstrated a statistically significant decline in the relative AMI mortality risk for females when compared with males (<0.001).

Conclusion.

Over the last decade, in-hospital AMI mortality rates declined for every age/sex group except males <55 years.

While AMI female-male mortality disparity has narrowed, some room for improvement remains.