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Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina

BACKGROUND: Natural disasters, war, and terrorist attacks, have been linked to cardiac mortality. We sought to investigate whether a major financial crisis may impact on the medical management and outcomes of acute coronary syndromes. METHODS: We analyzed the Argentine cohort of the international mu...

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Autores principales: Gurfinkel, Enrique P, Bozovich, Gerardo E, Dabbous, Omar, Mautner, Branco, Anderson, Frederick
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2005
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325268/
https://www.ncbi.nlm.nih.gov/pubmed/16351728
http://dx.doi.org/10.1186/1477-9560-3-22
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author Gurfinkel, Enrique P
Bozovich, Gerardo E
Dabbous, Omar
Mautner, Branco
Anderson, Frederick
author_facet Gurfinkel, Enrique P
Bozovich, Gerardo E
Dabbous, Omar
Mautner, Branco
Anderson, Frederick
author_sort Gurfinkel, Enrique P
collection PubMed
description BACKGROUND: Natural disasters, war, and terrorist attacks, have been linked to cardiac mortality. We sought to investigate whether a major financial crisis may impact on the medical management and outcomes of acute coronary syndromes. METHODS: We analyzed the Argentine cohort of the international multicenter Global Registry of Acute Coronary Events (GRACE). The primary objective was to estimate if there was an association between the financial crisis period (April 1999 to December 2002) and in- hospital cardiovascular mortality, with the post-crisis period (January 2003 to September 2004) as the referent. Each period was defined according to the evolution of the Gross Domestic Product. We investigated the demographic characteristics, diagnostic and therapeutic procedures, morbidity and mortality. RESULTS: We analyzed data from 3220 patients, 2246 (69.8%) patients in the crisis period and 974 (30.2%) in the post-crisis frame. The distribution of demographic and clinical baseline characteristics were not significantly different between both periods. During the crisis period the incidence of in-hospital myocardial infarction was higher (6.9% Vs 2.9%; p value < 0.0001), as well as congestive heart failure (16% Vs 11%; p value < 0.0001). Time to intervention with angioplasty was longer during the crisis, especially among public sites (median 190 min Vs 27 min). The incidence proportion of mortality during hospitalization was 6.2% Vs 5.1% after crisis. The crude OR for mortality was 1.2 (95% C.I. 0.87, 1.7). The odds for mortality were higher among private institutions {1.9 (95% C.I. 0.9, 3.8)} than for public centers {1.2 (95% C.I. 0.83, 1.79)}. We did not observe a significant interaction between type of hospital and crisis. CONCLUSION: Our findings suggest that the financial crisis may have had a negative impact on cardiovascular mortality during hospitalization, and higher incidence of medical complications.
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spelling pubmed-13252682006-01-07 Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina Gurfinkel, Enrique P Bozovich, Gerardo E Dabbous, Omar Mautner, Branco Anderson, Frederick Thromb J Original Clinical Investigation BACKGROUND: Natural disasters, war, and terrorist attacks, have been linked to cardiac mortality. We sought to investigate whether a major financial crisis may impact on the medical management and outcomes of acute coronary syndromes. METHODS: We analyzed the Argentine cohort of the international multicenter Global Registry of Acute Coronary Events (GRACE). The primary objective was to estimate if there was an association between the financial crisis period (April 1999 to December 2002) and in- hospital cardiovascular mortality, with the post-crisis period (January 2003 to September 2004) as the referent. Each period was defined according to the evolution of the Gross Domestic Product. We investigated the demographic characteristics, diagnostic and therapeutic procedures, morbidity and mortality. RESULTS: We analyzed data from 3220 patients, 2246 (69.8%) patients in the crisis period and 974 (30.2%) in the post-crisis frame. The distribution of demographic and clinical baseline characteristics were not significantly different between both periods. During the crisis period the incidence of in-hospital myocardial infarction was higher (6.9% Vs 2.9%; p value < 0.0001), as well as congestive heart failure (16% Vs 11%; p value < 0.0001). Time to intervention with angioplasty was longer during the crisis, especially among public sites (median 190 min Vs 27 min). The incidence proportion of mortality during hospitalization was 6.2% Vs 5.1% after crisis. The crude OR for mortality was 1.2 (95% C.I. 0.87, 1.7). The odds for mortality were higher among private institutions {1.9 (95% C.I. 0.9, 3.8)} than for public centers {1.2 (95% C.I. 0.83, 1.79)}. We did not observe a significant interaction between type of hospital and crisis. CONCLUSION: Our findings suggest that the financial crisis may have had a negative impact on cardiovascular mortality during hospitalization, and higher incidence of medical complications. BioMed Central 2005-12-13 /pmc/articles/PMC1325268/ /pubmed/16351728 http://dx.doi.org/10.1186/1477-9560-3-22 Text en Copyright © 2005 Gurfinkel et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Clinical Investigation
Gurfinkel, Enrique P
Bozovich, Gerardo E
Dabbous, Omar
Mautner, Branco
Anderson, Frederick
Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina
title Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina
title_full Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina
title_fullStr Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina
title_full_unstemmed Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina
title_short Socio economic crisis and mortality. Epidemiological testimony of the financial collapse of Argentina
title_sort socio economic crisis and mortality. epidemiological testimony of the financial collapse of argentina
topic Original Clinical Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325268/
https://www.ncbi.nlm.nih.gov/pubmed/16351728
http://dx.doi.org/10.1186/1477-9560-3-22
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