BACKGROUND: There are no previous studies investigating when and where those who die pre-hospitally after an AMI paid their last visit to medical care. METHODS AND RESULTS: Incidence of AMI, pre-hospital and 28-day case fatality rates were monitored over 13 years of follow-up, in relation to sex-specific quartiles of annual income in all inhabitants aged 40-64 years in Malmö, Sweden. Both incidence and short-term case fatality were inversely related to income. In all, 60-70% of all deaths within 28 days after the AMI were pre-hospital deaths. As compared with the lowest income group, the highest income group had lower odds of pre-hospital death with an age- and time-to-event-adjusted odds ratio of 0.5 (95% CI 0.4-0.8) for men and 0.3 (95% CI 0.1-0.6) for women. On the other hand, while 72% of those in the lowest two income groups had paid a visit to the medical services during the three months before death, only 59% had done so in the two highest income groups (P < 0.05). CONCLUSIONS: Poor socioeconomic circumstances increase the risk of pre-hospital death after an AMI. Of the pre-hospital deaths, the proportion who had visited the medical services during the 3 months preceding their AMI was higher among those from lower income groups. However, many of those suffering a pre-hospital death had visited clinics that normally do not treat coronary symptoms. If more patients were identified at an earlier stage this might increase the number of patients reaching hospital alive.
BACKGROUND: There are no previous studies investigating when and where those who die pre-hospitally after an AMI paid their last visit to medical care. METHODS AND RESULTS: Incidence of AMI, pre-hospital and 28-day case fatality rates were monitored over 13 years of follow-up, in relation to sex-specific quartiles of annual income in all inhabitants aged 40-64 years in Malmö, Sweden. Both incidence and short-term case fatality were inversely related to income. In all, 60-70% of all deaths within 28 days after the AMI were pre-hospital deaths. As compared with the lowest income group, the highest income group had lower odds of pre-hospital death with an age- and time-to-event-adjusted odds ratio of 0.5 (95% CI 0.4-0.8) for men and 0.3 (95% CI 0.1-0.6) for women. On the other hand, while 72% of those in the lowest two income groups had paid a visit to the medical services during the three months before death, only 59% had done so in the two highest income groups (P < 0.05). CONCLUSIONS: Poor socioeconomic circumstances increase the risk of pre-hospital death after an AMI. Of the pre-hospital deaths, the proportion who had visited the medical services during the 3 months preceding their AMI was higher among those from lower income groups. However, many of those suffering a pre-hospital death had visited clinics that normally do not treat coronary symptoms. If more patients were identified at an earlier stage this might increase the number of patients reaching hospital alive.
Authors: Jonas Hermansson; Katja Gillander Gådin; Berndt Karlsson; Christina Reuterwall; Johan Hallqvist; Anders Knutsson Journal: Int Arch Occup Environ Health Date: 2014-09-27 Impact factor: 3.015
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Authors: Aloysia A M van Oeffelen; Charles Agyemang; Michiel L Bots; Karien Stronks; Carla Koopman; Lenie van Rossem; Ilonca Vaartjes Journal: Eur J Epidemiol Date: 2012-06-05 Impact factor: 8.082
Authors: Merete Osler; Eva Prescott; Ida Kim Wium-Andersen; Else Helene Ibfelt; Martin Balslev Jørgensen; Per Kragh Andersen; Terese Sara Høj Jørgensen; Marie Kim Wium-Andersen; Solvej Mårtensson Journal: PLoS One Date: 2015-10-29 Impact factor: 3.240
Authors: Inge Kirchberger; Christa Meisinger; Hildegard Golüke; Margit Heier; Bernhard Kuch; Annette Peters; Philip A Quinones; Wolfgang von Scheidt; Andreas Mielck Journal: Int J Equity Health Date: 2014-02-19