Influence of seasons on the management and outcomes acute myocardial infarction: An 18-year US study.
Aged
Coronary Angiography
Disease Management
Female
Follow-Up Studies
Forecasting
Hospital Mortality
/ trends
Hospitalization
/ statistics & numerical data
Humans
Male
Myocardial Infarction
/ diagnosis
Percutaneous Coronary Intervention
/ methods
Prevalence
Retrospective Studies
Seasons
United States
/ epidemiology
acute myocardial infarction
healthcare disparities
outcomes research
season
winter
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
03
06
2020
revised:
10
07
2020
accepted:
14
07
2020
pubmed:
8
8
2020
medline:
11
8
2021
entrez:
8
8
2020
Statut:
ppublish
Résumé
There are limited data on the seasonal variation in acute myocardial infarction (AMI) in the contemporary literature. There would be decrease in the seasonal variation in the management and outcomes of AMI. Adult (>18 years) AMI admissions were identified using the National Inpatient Sample (2000-2017). Seasons were classified as spring, summer, fall, and winter. Outcomes of interest included prevalence, in-hospital mortality, use of coronary angiography, and percutaneous coronary intervention (PCI). Subgroup analyses for type of AMI and patient characteristics were performed. Of the 10 880 856 AMI admissions, 24.3%, 22.9%, 22.2%, and 24.2% were admitted in spring, summer, fall, and winter, respectively. The four cohorts had comparable age, sex, race, and comorbidities distribution. Rates of coronary angiography and PCI were slightly but significantly lower in winter (62.6% and 40.7%) in comparison to the other seasons (64-65% and 42-43%, respectively) (P < .001). Compared to spring, winter admissions had higher in-hospital mortality (adjusted odds ratio [aOR]: 1.07; 95% confidence interval [CI]: 1.06-1.08), whereas summer (aOR 0.97; 95% CI 0.96-0.98) and fall (aOR 0.98; 95% CI 0.97-0.99) had slightly lower in-hospital mortality (P < .001). ST-segment elevation (10.0% vs 9.1%; aOR 1.07; 95% CI 1.06-1.08) and non-ST-segment elevation (4.7% vs 4.2%; aOR 1.07; 95% CI 1.06-1.09) AMI admissions in winter had higher in-hospital mortality compared to spring (P < .001). The primary results were consistent when stratified by age, sex, race, geographic region, and admission year. Compared to other seasons, winter admission was associated with higher in-hospital mortality in AMI in the United States.
Sections du résumé
BACKGROUND
BACKGROUND
There are limited data on the seasonal variation in acute myocardial infarction (AMI) in the contemporary literature.
HYPOTHESIS
OBJECTIVE
There would be decrease in the seasonal variation in the management and outcomes of AMI.
METHODS
METHODS
Adult (>18 years) AMI admissions were identified using the National Inpatient Sample (2000-2017). Seasons were classified as spring, summer, fall, and winter. Outcomes of interest included prevalence, in-hospital mortality, use of coronary angiography, and percutaneous coronary intervention (PCI). Subgroup analyses for type of AMI and patient characteristics were performed.
RESULTS
RESULTS
Of the 10 880 856 AMI admissions, 24.3%, 22.9%, 22.2%, and 24.2% were admitted in spring, summer, fall, and winter, respectively. The four cohorts had comparable age, sex, race, and comorbidities distribution. Rates of coronary angiography and PCI were slightly but significantly lower in winter (62.6% and 40.7%) in comparison to the other seasons (64-65% and 42-43%, respectively) (P < .001). Compared to spring, winter admissions had higher in-hospital mortality (adjusted odds ratio [aOR]: 1.07; 95% confidence interval [CI]: 1.06-1.08), whereas summer (aOR 0.97; 95% CI 0.96-0.98) and fall (aOR 0.98; 95% CI 0.97-0.99) had slightly lower in-hospital mortality (P < .001). ST-segment elevation (10.0% vs 9.1%; aOR 1.07; 95% CI 1.06-1.08) and non-ST-segment elevation (4.7% vs 4.2%; aOR 1.07; 95% CI 1.06-1.09) AMI admissions in winter had higher in-hospital mortality compared to spring (P < .001). The primary results were consistent when stratified by age, sex, race, geographic region, and admission year.
CONCLUSIONS
CONCLUSIONS
Compared to other seasons, winter admission was associated with higher in-hospital mortality in AMI in the United States.
Identifiants
pubmed: 32761957
doi: 10.1002/clc.23428
pmc: PMC7533976
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1175-1185Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR000135
Pays : United States
Informations de copyright
© 2020 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
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