Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland.
Department of Health Care Services, Polish National Health Fund, Central Office in Warsaw, Warszawa, Poland.
Kardiol Pol. 2022;80(3):415-321. doi: 10.33963/KP.a2022.0035. Epub 2022 Feb 7.
This study aimed to analyze survival rates among patients with acute coronary syndrome (ACS) covered and not covered by the National Comprehensive Care after Myocardial Infarction (KOS-Zawał) program.
A total of 179972 patients after myocardial infarction (MI) were enrolled in KOS-Zawał program between October 2017 and March 2020 and were included in the comparative analysis with survival analysis. A group of 24496 (13.61%) patients received KOS-Zawał services, while a group of 155476 (86.39%) were not covered by the KOS-Zawał program. The time points for observation of the incidence of death were set at 30, 180, and 365 days from the end of the first hospitalization.
There was a lower incidence of death in favor of the KOS-Zawał group relative to the non-KOS-Zawał group both in hospital and at 30, 180, and 365 days after the end of hospitalization, respectively: 0.19% vs. 6.55%; 0.80% vs. 8.39%; 2.92% vs. 10.74%; and 6.35% vs. 13.40%. Survival analysis revealed a statistically significantly lower (P <0.0001) probability of death in the KOS-Zawał group compared with the non-KOS-Zawał group. Also, logistic regression analysis confirmed that patients in the KOS-Zawał group had a significantly lower risk of death than those in the non-KOS-Zawał group (odds ratio, 0.710; 95% confidence interval, 0.554-0.908; P = 0.007).
The KOS-Zawał comprehensive care program reduces the risk of death in the first year after MI by 29%. There are indications of a biased interpretation of the data due to the initial better clinical status of post-MI patients covered by the KOS-Zawał program.
本研究旨在分析接受和未接受国家心肌梗死综合关怀后急性冠脉综合征（ACS）方案（KOS-Zawał）的患者的生存率。
共有 179972 名心肌梗死（MI）后患者于 2017 年 10 月至 2020 年 3 月期间纳入 KOS-Zawał 方案，并进行生存分析比较分析。一组 24496 例（13.61%）患者接受 KOS-Zawał 服务，另一组 155476 例（86.39%）未接受 KOS-Zawał 方案。观察死亡发生率的时间点分别为首次住院结束后 30、180 和 365 天。
KOS-Zawał 组与非 KOS-Zawał 组相比，住院期间及住院结束后 30、180 和 365 天的死亡率均较低：0.19%比 6.55%；0.80%比 8.39%；2.92%比 10.74%；6.35%比 13.40%。生存分析显示，KOS-Zawał 组的死亡概率明显低于非 KOS-Zawał 组（P<0.0001）。此外，逻辑回归分析证实，KOS-Zawał 组患者的死亡风险明显低于非 KOS-Zawał 组（比值比，0.710；95%置信区间，0.554-0.908；P=0.007）。
KOS-Zawał 综合关怀方案可降低 MI 后第一年的死亡风险 29%。由于 KOS-Zawał 方案覆盖的 MI 后患者初始临床状况较好，因此存在数据偏倚解释的迹象。
