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25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a Danish nationwide cohort study

Objectives To examine 25 year trends in first time hospitalisation for acute myocardial infarction in Denmark, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity. Design Nationwide population based cohort study using medical registries. Setting All hospitals i...

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Autores principales: Schmidt, Morten, Jacobsen, Jacob Bonde, Lash, Timothy L, Bøtker, Hans Erik, Sørensen, Henrik Toft
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266429/
https://www.ncbi.nlm.nih.gov/pubmed/22279115
http://dx.doi.org/10.1136/bmj.e356
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author Schmidt, Morten
Jacobsen, Jacob Bonde
Lash, Timothy L
Bøtker, Hans Erik
Sørensen, Henrik Toft
author_facet Schmidt, Morten
Jacobsen, Jacob Bonde
Lash, Timothy L
Bøtker, Hans Erik
Sørensen, Henrik Toft
author_sort Schmidt, Morten
collection PubMed
description Objectives To examine 25 year trends in first time hospitalisation for acute myocardial infarction in Denmark, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity. Design Nationwide population based cohort study using medical registries. Setting All hospitals in Denmark. Subjects 234 331 patients with a first time hospitalisation for myocardial infarction from 1984 through 2008. Main outcome measures Standardised incidence rate of myocardial infarction and 30 day and 31–365 day mortality by sex. Comorbidity categories were defined as normal, moderate, severe, and very severe according to the Charlson comorbidity index, and were compared by means of mortality rate ratios based on Cox regression. Results The standardised incidence rate per 100 000 people decreased in the 25 year period by 37% for women (from 209 to 131) and by 48% for men (from 410 to 213). The 30 day, 31–365 day, and one year mortality declined from 31.4%, 15.6%, and 42.1% in 1984–8 to 14.8%, 11.1%, and 24.2% in 2004–8, respectively. After adjustment for age at time of myocardial infarction, men and women had the same one year risk of dying. The mortality reduction was independent of comorbidity category. Comparing patients with very severe versus normal comorbidity during 2004–8, the mortality rate ratio, adjusted for age and sex, was 1.96 (95% CI 1.83 to 2.11) within 30 days and 3.89 (3.58 to 4.24) within 31–365 days. Conclusions The rate of first time hospitalisation for myocardial infarction and subsequent short term mortality both declined by nearly half between 1984 and 2008. The reduction in mortality occurred for all patients, independent of sex and comorbidity. However, comorbidity burden was a strong prognostic factor for short and long term mortality, while sex was not.
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spelling pubmed-32664292012-01-31 25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a Danish nationwide cohort study Schmidt, Morten Jacobsen, Jacob Bonde Lash, Timothy L Bøtker, Hans Erik Sørensen, Henrik Toft BMJ Research Objectives To examine 25 year trends in first time hospitalisation for acute myocardial infarction in Denmark, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity. Design Nationwide population based cohort study using medical registries. Setting All hospitals in Denmark. Subjects 234 331 patients with a first time hospitalisation for myocardial infarction from 1984 through 2008. Main outcome measures Standardised incidence rate of myocardial infarction and 30 day and 31–365 day mortality by sex. Comorbidity categories were defined as normal, moderate, severe, and very severe according to the Charlson comorbidity index, and were compared by means of mortality rate ratios based on Cox regression. Results The standardised incidence rate per 100 000 people decreased in the 25 year period by 37% for women (from 209 to 131) and by 48% for men (from 410 to 213). The 30 day, 31–365 day, and one year mortality declined from 31.4%, 15.6%, and 42.1% in 1984–8 to 14.8%, 11.1%, and 24.2% in 2004–8, respectively. After adjustment for age at time of myocardial infarction, men and women had the same one year risk of dying. The mortality reduction was independent of comorbidity category. Comparing patients with very severe versus normal comorbidity during 2004–8, the mortality rate ratio, adjusted for age and sex, was 1.96 (95% CI 1.83 to 2.11) within 30 days and 3.89 (3.58 to 4.24) within 31–365 days. Conclusions The rate of first time hospitalisation for myocardial infarction and subsequent short term mortality both declined by nearly half between 1984 and 2008. The reduction in mortality occurred for all patients, independent of sex and comorbidity. However, comorbidity burden was a strong prognostic factor for short and long term mortality, while sex was not. BMJ Publishing Group Ltd. 2012-01-25 /pmc/articles/PMC3266429/ /pubmed/22279115 http://dx.doi.org/10.1136/bmj.e356 Text en © Schmidt et al 2012 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
spellingShingle Research
Schmidt, Morten
Jacobsen, Jacob Bonde
Lash, Timothy L
Bøtker, Hans Erik
Sørensen, Henrik Toft
25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a Danish nationwide cohort study
title 25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a Danish nationwide cohort study
title_full 25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a Danish nationwide cohort study
title_fullStr 25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a Danish nationwide cohort study
title_full_unstemmed 25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a Danish nationwide cohort study
title_short 25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a Danish nationwide cohort study
title_sort 25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: a danish nationwide cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266429/
https://www.ncbi.nlm.nih.gov/pubmed/22279115
http://dx.doi.org/10.1136/bmj.e356
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