Department of Public Health, HSE, Dublin, Ireland.
Heart. 2012 Sep;98(17):1285-9. doi: 10.1136/heartjnl-2012-301822. Epub 2012 Jul 16.
To study the temporal and gender trends in age-standardised hospitalisation rates, in-hospital mortality rates and indicators of health service use for acute myocardial infarction (AMI), and the sub-categories, ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI), in Ireland, 1997-2008.
DESIGN, SETTING, PATIENTS: Anonymised data from the hospital inpatient enquiry were studied for the ICD codes covering STEMI and NSTEMI in all 39 acute hospitals in Ireland over a 12-year period. Age standardisation (direct method) was used to study hospitalisation and in-hospital mortality rates. Joinpoint regression analysis was undertaken to identify significant inflection points in hospitalisation trends.
Age-standardised hospitalisation rates, in-hospital mortality and indicators of health service use (length of stay, bed days) for AMI, STEMI and NSTEMI patients.
From 1997 to 2008, hospitalisation rates for AMI decreased by 27%, and by 68% for STEMI patients (test for trend p<0.001), and increased by 122% for NSTEMI, (test for trend p<0.001). The mean age of male STEMI patients decreased (p<0.01), while those for the remaining groupings of AMI and subcategories increased. The proportion of males increased significantly for STEMI and NSTEMI (p<0.001). In-hospital mortality decreased steadily (p=0.01 STEMI, p=0.02 NSTEMI), as did median length of stay.
The authors found a steady decrease in hospitalisation rates with AMI, and a shift away from STEMI towards rising rates of NSTEMI patients who are increasingly older. In an ageing population, and with increasing survival rates, surveillance of acute coronary syndrome and allied conditions is necessary to inform clinicians and policy makers.
研究爱尔兰 1997-2008 年急性心肌梗死（AMI）患者年龄标准化住院率、住院死亡率和卫生服务利用指标的时间和性别趋势，以及 ST 段抬高型心肌梗死（STEMI）和非 ST 段抬高型心肌梗死（NSTEMI）的亚组。
设计、地点、患者：对爱尔兰 39 家急性医院 12 年间涵盖 STEMI 和 NSTEMI 的 ICD 编码的住院患者询问匿名数据进行研究。使用年龄标准化（直接法）研究住院率和住院死亡率。采用联合回归分析确定住院趋势的显著拐点。
AMI、STEMI 和 NSTEMI 患者的年龄标准化住院率、住院死亡率和卫生服务利用（住院时间、床位日）指标。
从 1997 年到 2008 年，AMI 的住院率下降了 27%，STEMI 患者的住院率下降了 68%（趋势检验 p<0.001），NSTEMI 的住院率上升了 122%（趋势检验 p<0.001）。男性 STEMI 患者的平均年龄降低（p<0.01），而其余 AMI 和亚组的平均年龄增加。STEMI 和 NSTEMI 的男性比例显著增加（p<0.001）。住院死亡率稳步下降（p=0.01 STEMI，p=0.02 NSTEMI），住院时间中位数也下降。
作者发现 AMI 的住院率稳步下降，STEMI 向 NSTEMI 转移，年龄较大的 NSTEMI 患者比例上升。在人口老龄化和生存率提高的情况下，有必要对急性冠状动脉综合征和相关疾病进行监测，为临床医生和政策制定者提供信息。
