Open AccessTwenty‐eight day and one‐year case fatality after hospitalisation with an acute coronary syndrome: a nationwide data linkage study
Author(s) -
Grey Corina,
Jackson Rod,
Wells Susan,
Marshall Roger,
Riddell Tania,
Kerr Andrew J.
Publication year - 2014
Publication title -
australian and new zealand journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.946
H-Index - 76
eISSN - 1753-6405
pISSN - 1326-0200
DOI - 10.1111/1753-6405.12241
Subject(s) - medicine , case fatality rate , acute coronary syndrome , unstable angina , ethnic group , demography , cohort , proportional hazards model , socioeconomic status , pediatrics , record linkage , emergency medicine , myocardial infarction , epidemiology , population , environmental health , sociology , anthropology
Objectives : To determine 28‐day and one‐year case fatality in patients hospitalised with acute coronary syndromes (ACS) and identify factors associated with mortality. Methods : All New Zealand residents admitted with ACS between 2007 and 2009 were followed for one year using individual patient linkage of national hospitalisation and mortality datasets. Deaths from any cause were used to calculate 28‐day and one‐year case fatality. Cox‐proportional hazards models were constructed to identify factors associated with mortality after an ACS hospitalisation. Results : The cohort included 42,920 ACS patients. Case fatality increased steeply with age. Māori and Pacific peoples had 1.5 times the risk of 28‐day, and twice the risk of one‐year, mortality as Europeans/Others. Low (compared to high) socioeconomic status was associated with significantly higher mortality at 28 days but not one year. Patients with unstable angina had half the risk of short‐term mortality as NSTEMI patients, whereas STEMI patients had double the NSTEMI risk. Conclusions and Implications : The major determinant of increasing case fatality was increasing age. There were also substantial differences in case fatality by ethnicity, deprivation and diagnostic category. Further research is needed to explore the possible mechanisms by which ethnic and deprivation disparities occur and effective strategies to address them.