In:
Das Gesundheitswesen, Georg Thieme Verlag KG, Vol. 83, No. 04 ( 2021-04), p. 291-296
Abstract:
During the past 2 decades, improvement and advancements in coronary reperfusion
and optimized medical therapy have enabled a marked reduction of hospital mortality in patients with myocardial infarction, while pre-hospital mortality
has not been favourably influenced in equal measure. This study aims at describing those who died from myocardial infarction during one year in the city
of Berlin, with particular focus on the comparison of in-hospital versus out-of-hospital mortality. Methods We examined data from centrally archived death certificates
issued between July 2014 and June 2015 and identified 1076 cases of myocardial infarction; the certificates stated that myocardial infarction was the direct
cause of death in explicit words or by reference to ICD codes. All cases were included in our study anonymously. Results During the study period, 1076 deaths from myocardial infarction
were identified; 66% died out of hospital, whereas 34% died in a hospital. There were no differences between those dying in and those out of
hospital in the percentage of women (40.4% in, 39.0% out of hospital; p=0.671), frequency of post-mortem examinations
(16.8–16.6%; p=0.938) or in death category “not natural” and “uncertain” (17.1–19.3%;
p=0.388). There were differences in age and month of death. Those dying outside of the hospital were on average younger (76 yrs.) than those dying in
hospital (80 yrs.). The biggest differences were seen in the youngest age groups 〈 65 years with 76.3% dying out of hospital and
23.7% in hospital. Between July and September, the relative proportion of those dying out of hospital was lowest (15.4%), and for those dying
in hospital, this proportion was the highest (29.4%). This tendency was the same for men and women as well as younger and older patients. Conclusion In this study, two-thirds of deaths from myocardial infarction
occurred outside of the hospital. Out-of-hospital death occurs predominantly among younger individuals and varies by season of the year. The high level of
pre-hospital deaths from myocardial infarction should stimulate intense efforts to improve prevention and emergency management of patients based on scientific
evaluation.
Type of Medium:
Online Resource
ISSN:
0941-3790
,
1439-4421
Language:
German
Publisher:
Georg Thieme Verlag KG
Publication Date:
2021
detail.hit.zdb_id:
1101426-X
SSG:
20,1
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