Clinical research studyAcute Myocardial Infarction Hospitalization in the United States, 1979 to 2005
Section snippets
Data Sources
The National Hospital Discharge Survey (NHDS) 1979-2005 was conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention. The NHDS collected annual data from a sample of inpatient records acquired from a national sample of hospitals. General hospitals or children's general hospitals, and hospitals with an average length of stay of fewer than 30 days for all patients were included in the survey. Federal, military, and Department of Veterans Affairs hospitals
Results
The total number of hospitalizations with the first-listed diagnosis of acute myocardial infarction was approximately 432,000 in 1979 and 681,000 in 2005, a 58% increase. Hospitalization rates were 194 and 231 per 100,000 population for 1979 and 2003, respectively. The mean (± standard deviation) age of patients was 67 ± 14 years (60% were aged ≥ 65 years), and 60% were men. Among acute myocardial infarction hospitalizations, women were older than men (71 ± 13 years vs 64 ± 13 years).
Discussion
From 1979 to 2005, acute myocardial infarction hospitalization rates increased from 194 to 231. These rates increased at first, then leveled off, and finally declined slowly. During this time, there were increases in use of cardiac catheterization, percutaneous transluminal coronary angioplasty, coronary artery bypass graft surgery, and thrombolytic drugs. Length of stay decreased substantially during this time, as did in-hospital case-fatality rates. In addition, disparities were noted by age
Conclusions
During the past quarter century, although coronary heart disease mortality has decreased, hospitalization for acute myocardial infarction has only begun to decline more recently. At the same time, there has been a trend toward more intensive acute care and vastly expanded use of invasive procedures associated with both shorter length of stay and decreasing in-hospital case-fatality rates.
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Funding: None.
Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Authorship: All authors had access to the data and played a role in writing this manuscript.