Abstract 312: Ten-year-trends In ST-elevation And Non-ST-elevation Myocardial Infarction Hospitalizations And Outcomes In The Us: Analysis Of Data From The Nationwide In-patient Sample 2000-2009
| Autor: | Arun Raghav Mahankali Sridhar, Vinodh Jeevanantham, Dhavalkumar B Patel, Kamal Gupta, Buddhadeb Dawn |
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| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 5 |
| ISSN: | 1941-7705 1941-7713 2000-2009 |
| DOI: | 10.1161/circoutcomes.5.suppl_1.a312 |
| Popis: | Background. The impact of advances in therapy and patient management on the trends in hospitalization, outcomes, costs and readmissions in patients with ST-elevation (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) remains unclear. Using a large database, we analyzed these trends over the course of 10 years. Methods. The 2000-2009 Nationwide In-patient Sample Database (the largest all-payer, in-patient database in the US) was used to identify patients with STEMI and NSTEMI, based on the ICD-9 discharge diagnosis codes. The trends for each diagnosis, the patient characteristics, hospital charges, and outcomes were analyzed. Results. During 2000-2009, 2.9 million patients were diagnosed with STEMI and 3.9 million with NSTEMI. The analyses of yearly data revealed a progressive and significant decline in the number of patients with STEMI over the decade ( P P =0.046) (Figure, Panel A) During the same time, the in-hospital mortality for STEMI decreased from 11.3% in 2000 to 8.6% in 2009, and for NSTEMI from 5.5% in 2000 to 4.0% in 2009 ( P P =0.003) and from 5.8 days in 2000 to 5.1 days in 2009 in patients with NSTEMI ( P P P P =0.05) (Figure, Panel D). Although the incidence of STEMI decreased across all age groups, the proportions of each age group accounting for either STEMI or NSTEMI did not change significantly over the years. The age-group 64-84 years accounted for the highest number of MI-related hospitalizations accounting for 46% and 53% of STEMIs and NSTEMIs, respectively. Gender-stratified analysis revealed that on average 58% STEMIs and 52% NSTEMIs occur in males and this distribution did not change significantly over the decade. Conclusions. During the 2000-2009 period, the incidence of STEMI has decreased progressively and significantly in the US, while the incidence of NSTEMI has increased. Although the decrease in mortality rates for patients with STEMI and NSTEMI is encouraging, the worrisome increase in costs associated with the index hospitalization, and the increase in rates of rehospitalization deserve further attention. |
| Databáze: | OpenAIRE |
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