Spatial distribution of in- and out-of-hospital mortality one year after acute myocardial infarction in France.
Spatial distribution of in- and out-of-hospital mortality one year after acute myocardial infarction in France.
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法国急性心肌梗塞一年后，空间分布的空间分布。
DOI：
10.1016/j.ajpc.2020.100037
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发表时间：
2020-06
影响因子：
4.1
通讯作者：
Quantin C
中科院分区：
文献类型：
--
作者：
Piccard M;Roussot A;Cottenet J;Cottin Y;Zeller M;Quantin C
描述法国急性心肌梗死（AMI）死亡率的空间分布与患者居住地的社会经济特征。在这项基于人群的研究中，我们纳入了根据ICD-10编码识别的AMI住院患者，使用了2013年1月1日至2014年12月31日国家健康保险数据库的数据。在AMI首次住院后1年内确定院内和院外死亡。进行了探索性分析，对面积分布进行分类。AMI死亡率的空间分析采用主成分分析，然后考虑到社会经济数据、经道路到达冠状动脉造影的时间、标准化住院患病率和1年死亡率，采用上升分层分类。在过去的2年中，有115，418名患者因诊断为AMI而住院。患者平均年龄为68 ± 15岁，大多数为男性（68.5%）。1年后总死亡率为12.2%。超过一半的患者（65.5%）接受了早期血运重建手术。标准化1年死亡率地图显示，高死亡率地理区域从法国东北部对角延伸到西南部。我们确定了6个不同的地区概况，标准化死亡率从每10万居民15.9到54.4不等。较高死亡率的空间分布与较低的社会经济水平有关。这些发现与冠状动脉造影的机会较少无关。AMI的患病率和1年死亡率存在相当大的地理差异。较低的保健指标的空间分布遵循社会不平等的分布。这项研究强调了将国家政策重点放在普及预防计划上的重要性，例如促进心脏康复和健康的生活方式。在法国，AMI的患病率和1年死亡率在全国各地不同。较高死亡率的空间分布与较低的社会经济地位有关。到冠状动脉造影的旅行时间似乎不会增加AMI的死亡率。
To describe the spatial distribution of acute myocardial infarction (AMI) mortality in France in association with the socio-economic characteristics of the patient’s place of residence. In this population-based study, we included patients hospitalized for AMI identified according to ICD-10 codes, using data from the national health insurance database from January 1, 2013 to December 31, 2014. In- and out-of-hospital deaths were identified over a period of 1 year following the first hospital stay for AMI. An exploratory analysis was performed to classify area profiles. The spatial analysis of AMI mortality was performed using a principal component analysis followed by an ascending hierarchical classification taking into account socio-economic data, access-time by road to coronary angiography, standardized in-hospital prevalence, and 1 year mortality. Over the 2 years, 115,418 patients were hospitalized with a diagnosis of AMI. Patients were a mean of 68 ± 15 years and most were men (68.5%). The overall mortality rate was 12.2% after 1 year. More than half of patients (65.5%) underwent an early revascularization procedure. The map of standardized 1 year mortality showed a geographic area of high mortality extending diagonally from north-east to south-west France. We identified 6 different area profiles with standardized mortality varying from 15.9 to 54.4 per 100,000 inhabitants. The spatial distribution of higher mortality was associated with lower socioeconomic levels. These findings were not associated with a lower access to coronary angiography. There are considerable geographical differences in the prevalence of AMI and 1 year mortality. The spatial distribution of lower healthcare indicators follows the distribution of social inequalities. This study highlights the importance of focusing national policies on universally accessible prevention programs such as the promotion cardiac rehabilitation and healthy lifestyles. In France, prevalence of AMI and 1 year mortality varies throughout the country. Spatial distribution of higher mortality is related to lower socioeconomic status. Travel-time to coronary angiography does not appear to increase mortality rates for AMI.
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影响因子：
6.2
作者：
Blais, Claudia;Hamel, Denis;Rinfret, Stephane
通讯作者：
Rinfret, Stephane
影响因子：
3.3
作者：
Ibanez, Borja;James, Stefan;Widimsky, Petr
通讯作者：
Widimsky, Petr
影响因子：
4.8
作者：
Combier, Evelyne;Charreire, Helene;Zeitlin, Jennifer
通讯作者：
Zeitlin, Jennifer
影响因子：
8.3
作者：
Insam, Charlene;Paccaud, Fred;Marques-Vidal, Pedro
通讯作者：
Marques-Vidal, Pedro
影响因子：
24.3
作者：
Abdulmalak, Caroline;Cottenet, Jonathan;Quantin, Catherine
通讯作者：
Quantin, Catherine