Wissenschaftliches Institut der AOK (WIdO), Kortrijker Strasse 1, Bonn, Germany.
Dtsch Arztebl Int. 2008 Apr;105(15):279-85. doi: 10.3238/arztebl.2008.0279. Epub 2008 Apr 11.
The results of previous studies of the association between gender and mortality following hospital admission due to acute myocardial infarction are inconsistent. National data for Germany have been lacking to date. Hence the objective of this study was to analyze this association on the basis of a nationwide dataset.
The analysis was carried out using insurance claims data from inpatients insured by the statutory health insurer AOK, whose main diagnosis was acute myocardial infarction and who were discharged from hospital in the years 2004 and 2005. Several mortality endpoints were used, including 30-day mortality and one-year mortality.
132 774 male and female patients were included. Crude analyses showed a pronounced excess mortality in women (odds ratio 30-day mortality = 1.65; 95% confidence interval = 1.59 to 1.70). However, after adjustment for age (in decentiles) practically equal mortality was observed for female and male patients (odds ratio 30-day mortality = 1.00; 95% confidence interval = 0.96 to 1.03). Only in the comparatively small group of male and female patients up to the age of 50 was a slightly increased mortality observed in women (odds ratio 30-day mortality = 1.09; 95% confidence interval = 0.85 to 1.40).
To our knowledge, this study is the first nationwide analysis focusing on the association between gender and survival following hospital admission due to acute myocardial infarction. Different results from earlier regional studies may be explained by selection bias or inadequate risk adjustment.
先前关于因急性心肌梗死住院后性别与死亡率之间关系的研究结果不一致。德国目前缺乏全国性数据。因此，本研究的目的是基于全国性数据集分析这种关联。
使用 AOK 法定健康保险公司住院患者的保险索赔数据进行分析，其主要诊断为急性心肌梗死，并且在 2004 年和 2005 年出院。使用了几个死亡率终点，包括 30 天死亡率和 1 年死亡率。
共纳入了 132774 名男性和女性患者。初步分析显示女性死亡率明显偏高（30 天死亡率的比值比为 1.65；95%置信区间为 1.59 至 1.70）。然而，在调整年龄（按十分位数）后，男女患者的死亡率实际上是相等的（30 天死亡率的比值比为 1.00；95%置信区间为 0.96 至 1.03）。只有在男性和女性患者年龄均在 50 岁以下的相对较小的患者群体中，女性的死亡率略高（30 天死亡率的比值比为 1.09；95%置信区间为 0.85 至 1.40）。
据我们所知，这是第一项关注因急性心肌梗死住院后性别与生存之间关系的全国性分析。早期区域研究的不同结果可能是由于选择偏差或风险调整不足所致。
