Abstract
Objectives
Coronary heart disease is leading cause of burden of disease in the Europe. One of the care
quality indicators is 30-day mortality after admission for acute myocardial infarction (AMI). Latvia has
one of the highest mentioned rate in OECD countries. Main task was to calculate 30-day AMI mortality
rate by AMI type (with and without ST-elevation) in Latvia by hospital level for finding possible factors
explained high mortality rates.
Methods
Admission data from National Health Service (governmental reimbursement system), had linked
with Register of Causes of Death by the period 2014–2017 at person level. Rate of all cause death occurring in and out of hospital within 30 days following hospital admissions for acute myocardial infarction
(ICD-10 codes I21-I22) was calculated (inclusion and exclusion criteria used by OECD). Results were
divided into two groups: ST and non-ST elevation AMI patients (STEMI and NSTEMI).
Results
There were identified 11 675 acute AMI admissions to 20 hospitals for time period – 4 years.
Average 30-days mortality for all AMI admissions was 17.4%. There were 9168 STEMI (78.5%) and
2507 NSTEMI cases (21.5%) for all hospitals admitting AMI patients. Proportion had not significant
changes during four-year period. For STEMI cases AMI mortality was 18.8%, for NONSTEMI – 12.2%.
The differences in proportion of AMI types between all 20 hospitals were huge: from 0.4% to 47.9%
(statistically significant). Lowest NSTEMI proportion was in a hospital where referred 25.5% of all AMI
patients.
Conclusions
The huge difference between hospitals in proportion of NSTEMI cases could not be explained as
randomness in patient distribution. It is linked with differences in coding tradition among hospitals.
NSTEMI type of AMI is undercounted in Latvia. It could be one of reasons explained relatively high rate
of 30-day AMI mortality.
Coronary heart disease is leading cause of burden of disease in the Europe. One of the care
quality indicators is 30-day mortality after admission for acute myocardial infarction (AMI). Latvia has
one of the highest mentioned rate in OECD countries. Main task was to calculate 30-day AMI mortality
rate by AMI type (with and without ST-elevation) in Latvia by hospital level for finding possible factors
explained high mortality rates.
Methods
Admission data from National Health Service (governmental reimbursement system), had linked
with Register of Causes of Death by the period 2014–2017 at person level. Rate of all cause death occurring in and out of hospital within 30 days following hospital admissions for acute myocardial infarction
(ICD-10 codes I21-I22) was calculated (inclusion and exclusion criteria used by OECD). Results were
divided into two groups: ST and non-ST elevation AMI patients (STEMI and NSTEMI).
Results
There were identified 11 675 acute AMI admissions to 20 hospitals for time period – 4 years.
Average 30-days mortality for all AMI admissions was 17.4%. There were 9168 STEMI (78.5%) and
2507 NSTEMI cases (21.5%) for all hospitals admitting AMI patients. Proportion had not significant
changes during four-year period. For STEMI cases AMI mortality was 18.8%, for NONSTEMI – 12.2%.
The differences in proportion of AMI types between all 20 hospitals were huge: from 0.4% to 47.9%
(statistically significant). Lowest NSTEMI proportion was in a hospital where referred 25.5% of all AMI
patients.
Conclusions
The huge difference between hospitals in proportion of NSTEMI cases could not be explained as
randomness in patient distribution. It is linked with differences in coding tradition among hospitals.
NSTEMI type of AMI is undercounted in Latvia. It could be one of reasons explained relatively high rate
of 30-day AMI mortality.
| Original language | English |
|---|---|
| Pages | 701 -701 |
| Publication status | Published - Apr 2019 |
| Externally published | Yes |
| Event | RSU International Research Conference 2019: Knowledge For Use In Practice - Riga, Latvia Duration: 1 Apr 2019 → 3 Apr 2019 https://conference2019.rsu.lv/general-information/about-conference https://conference2019.rsu.lv/general-information https://www.rsu.lv/zinatnes-nedela-2019 https://conference2019.rsu.lv/sites/default/files/documents/knowledge_for_use_in_practice_abstracts_rev.pdf |
Conference
| Conference | RSU International Research Conference 2019 |
|---|---|
| Country/Territory | Latvia |
| City | Riga |
| Period | 1/04/19 → 3/04/19 |
| Other | The Conference will be held within the framework of RSU Research Week 2019. RSU starptautiskā konference "Zināšanas praksei" medicīnas un veselības aprūpes nozarē 2019. |
| Internet address |
Field of Science*
- 3.3 Health sciences
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)