Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010.
Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010.
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DOI：
10.1016/j.jacc.2014.04.054
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发表时间：
2014-07-29
影响因子：
24
通讯作者：
Krumholz, Harlan M.
中科院分区：
文献类型：
--
作者：
Gupta, Aakriti;Wang, Yongfei;Spertus, John A.;Geda, Mary;Lorenze, Nancy;Nkonde-Price, Chileshe;D'Onofrio, Gail;Lichtman, Judith H.;Krumholz, Harlan M.
近年来发起的各种全国性运动的重点是患有急性心肌梗死的年轻女性。关于临床特征、住院率、住院时间(LOS)和死亡率的性别差异的当代纵向数据尚未得到检验。使用美国医院出院的大型全国性数据集，按年龄组和种族确定年轻急性心肌梗死患者的临床特征、住院率、LOS和住院死亡率的性别差异。使用国家住院患者样本(NIS)，我们比较了30-54岁的急性心肌梗死患者的临床特征、急性心肌梗死住院率、LOS和住院死亡率，并利用调查数据分析技术将他们分成2001-2010年的5年亚组。我们从NIS的数据中确定了30-54岁的患者中有230,684人因主要出院诊断为急性心肌梗死而住院，这代表了2001-2010年间美国估计有1,129,949人住院。在55岁或按性别分层的年龄组中，没有观察到急性心肌梗死住院率在统计学上显著下降。女性的合并症患病率较高，在整个研究期间，男女合并症的患病率均有所增加。在所有年龄段中，女性的LOS时间和住院死亡率都高于男性。然而，从2001年到2010年，观察到的女性住院死亡率显著下降(3.3%到2.3%，相对变化30.5%，趋势预测P=0.0001)；但男性没有下降(2.0%到1.8%，相对变化8.6%，趋势预测=0.6)。在过去的十年里，年轻人的急性心肌梗死住院率并没有下降。与年轻男性相比，年轻女性急性心肌梗死有更多的合并症、更长的LOS和更高的住院死亡率。
Various national campaigns launched in recent years focused on young women with acute myocardial infarction (AMI). Contemporary longitudinal data about sex differences in clinical characteristics, hospitalization rates, length of stay (LOS), and mortality have not been examined. To determine sex differences in clinical characteristics, hospitalization rates, LOS, and in-hospital mortality by age groups and race among young patients with AMI using a large national dataset of U.S. hospital discharges. Using the National Inpatient Sample (NIS), we compared clinical characteristics, AMI hospitalization rates, LOS, and in-hospital mortality for patients with AMI across ages 30–54 years, dividing them into 5-year subgroups from 2001–2010, using survey data analysis techniques. We identified 230,684 hospitalizations with a principal discharge diagnosis of AMI in 30–54-year-old patients from NIS data, representing an estimated 1,129,949 hospitalizations in the U.S. from 2001–2010. No statistically significant declines in AMI hospitalization rates were observed in the age groups <55 years, or stratified by sex. Prevalence of comorbidities was higher in women and increased among both sexes through the study period. Women had longer LOS and higher in-hospital mortality than men across all age groups. However, observed inhospital mortality declined significantly for women from 2001 to 2010 (3.3% to 2.3%, relative change 30.5%, p-for-trend<0.0001); but not for men (2.0% to 1.8%, relative change 8.6%, p-for-trend=0.6). AMI hospitalization rates for young people have not declined over the past decade. Young women with AMI have more comorbidity, longer LOS, and higher in-hospital mortality than young men.
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影响因子：
24
作者：
Matthews, Karen A.;Crawford, Sybil L.;Chae, Claudia U.;Everson-Rose, Susan A.;Sowers, Mary Fran;Sternfeld, Barbara;Sutton-Tyrrell, Kim
通讯作者：
Sutton-Tyrrell, Kim
影响因子：
37.8
作者：
Chen, Jersey;Normand, Sharon-Lise T.;Krumholz, Harlan M.
通讯作者：
Krumholz, Harlan M.
影响因子：
120.7
作者：
Hajjar, I;Kotchen, TA
通讯作者：
Kotchen, TA
影响因子：
4.4
作者：
Toth, Peter P.;Potter, Danielle;Ming, Eileen E.
通讯作者：
Ming, Eileen E.
影响因子：
3.5
作者：
Leifheit-Limson, Erica C.;Spertus, John A.;Lichtman, Judith H.
通讯作者：
Lichtman, Judith H.