Trends in hospitalisation for acute myocardial infarction in Ireland, 1997–2008
- 1Department of Public Health, HSE, Dublin, Ireland
- 2Department of Pharmacology and Therapeutics, St James Hospital, Dublin, Ireland
- Correspondence to Dr Siobhan M Jennings, Public Health, Dr Steevens Hospital, Steevens Lane, HSE, Dublin 8, Ireland;
Contributors All four authors contributed to the design of the research protocol; 2 authors (KB and ML) contributed to the analysis and statistical content. All four authors contributed to the interpretation of the analysis and writing of the article, with one author (SMJ) taking the lead in writing and coordinating the work.
- Accepted 24 May 2012
- Published Online First 16 July 2012
Objective 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.
Main outcome measures Age-standardised hospitalisation rates, in-hospital mortality and indicators of health service use (length of stay, bed days) for AMI, STEMI and NSTEMI patients.
Results 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.
Conclusions 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.
- Quality of care and outcomes
- myocardial ischaemia and infarction (IHD)
- allied specialities
- transient ischaemic attack (TIA)
- great vessels and trauma
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.