Trends in case-fatality in 117718 patients admitted with acute myocardial infarction in Scotland

• Published in: European heart journal 2000-11, Vol.21 (22), p.1833-1840
• Main Authors: Capewell, S, Livingston, B.M, MacIntyre, K, Chalmers, J.W.T, Boyd, J, Finlayson, A, Redpath, A, Pell, J.P, Evans, C.J, McMurray, J.J.V
• Format: Article
• Language: English
• Subjects: Acute myocardial infarction; coronary heart disease; mortality; trends
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1053/euhj.2000.2318

Objectives To analyse short- and long-term case-fatality trends following admission to hospital with a first acute myocardial infarction, in men and women between 1986 and 1995, after adjusting for risk factors known to influence survival. Design A Scottish-wide retrospective cohort study. Setting The Linked Scottish Morbidity Record Database was analysed. This contains accurate data on all hospital admissions since 1981, for the Scottish population of 5·1 million. It is linked to the Registrar General's death certificate data. Subjects All 117718 patients admitted to Scottish hospitals with a principal diagnosis of first acute myocardial infarction (ICD-9 code 410) between 1986 and 1995. Main Outcome Measures The outcome was death, both in and out of hospital, from any cause, at 30 days, 1 year, 5 and 10 years. Results Overall case-fatality following hospital admission with acute myocardial infarction was 22·2%, 31·4%, 51·1% and 64·0% at 1 month, 1 year, 5 and 10 years, respectively. Multivariate analyses identified statistically significant independent prognostic factors. Thirty day mortality increased twofold for each decade of increasing age, and increased with any prior admission to hospital. When comparing the most deprived category to that of the most affluent, men had a 10% increased mortality (P