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BMJ. 1997 Jul 19;315(7101):159-64.

Inpatient deaths from acute myocardial infarction, 1982-92: analysis of data in the Nottingham heart attack register.

Author information

1
Division of Cardiovascular Medicine, University Hospital, Queen's Medical Centre, Nottingham.

Abstract

OBJECTIVE:

To assess longitudinal trends in admissions, management, and inpatient mortality from acute myocardial infarction over 10 years.

DESIGN:

Retrospective analysis based on the Nottingham heart attack register.

SETTING:

Two district general hospitals serving a defined urban and rural population.

SUBJECTS:

All patients admitted with a confirmed acute myocardial infarction during 1982-4 and 1989-92 (excluding 1991, when data were not collected).

MAIN OUTCOME MEASURES:

Numbers of patients, background characteristics, time from onset of symptoms to admission, ward of admission, treatment, and inpatient mortality.

RESULTS:

Admissions with acute myocardial infarction increased from 719 cases in 1982 to 960 in 1992. The mean age increased from 62.1 years to 66.6 years (P < 0.001), the duration of stay fell from 8.7 days to 7.2 days (P < 0.001), and the proportion of patients aged 75 years and over admitted to a coronary care unit increased significantly from 29.1% to 61.2%. A higher proportion of patients were admitted to hospital within 6 hours of onset of their symptoms in 1989-92 than in 1982-4, but 15% were still admitted after the time window for thrombolysis. Use of beta blockers increased threefold between 1982 and 1992, aspirin was used in over 70% of patients after 1989, and thrombolytic use increased 1.3-fold between 1989 and 1992. Age and sex adjusted odds ratios for inpatient mortality remained unchanged over the study period.

CONCLUSIONS:

Despite an increasing uptake of the "proved" treatments, inpatient mortality from myocardial infarction did not change between 1982 and 1992.

PMID:
9251546
PMCID:
PMC2127135
[Indexed for MEDLINE]
Free PMC Article

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