title: Comparison of in-hospital mortality from myocardial infarction in the pre- and post-thrombolysis eras at the Royal University Hospital, Saskatoon, Saskatchewan.
abstract: OBJECTIVE
  To compare in-hospital mortality of acute myocardial infarction (AMI) in two groups of patients in the pre- (1978-79) and post- (1990-91) thrombolysis era via a retrospective study.
  
  
  METHODS
  Hospital files of patients discharged from the Royal University Hospital (RUH) in Saskatoon, Saskatchewan with the diagnosis of AMI.
  
  
  RESULTS
  The diagnosis of AMI was established in 125 patients in 1978-79 and in 164 patients in 1990-91. The two groups were comparable with exceptions noted in the recorded family history of myocardial infarction and hypercholesterolemia. The overall in-hospital mortality decreased from 21.6% (1978-79) to 11.0% (1990-91; P = 0.05). The difference was more significant for patients admitted directly to the RUH, 24.0% (1978-79) versus 7.0% (1990-91; P = 0.05), and for patients over the age of 70 years. Marked differences were observed in the treatments provided to patients between these two decades.
  
  
  CONCLUSIONS
  The in-hospital mortality of patients with AMI has decreased considerably in the past two decades. The use of thrombolytic agents, acetylsalicylic acid, heparin and beta-blockers may have contributed to these changes. A worse prognosis was observed with advancing age, hypotension on admission and the development of congestive heart failure, malignant arrhythmias or shock.
authors.affiliation: Department of Medicine, University of Saskatchewan, Saskatoon.
authors.forename: K
authors.initials: K
authors.lastname: O'Reilly
authors.forename: J F
authors.initials: JF
authors.lastname: López
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006753:Hospital Records; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality*; D012189:Retrospective Studies; D012525:Saskatchewan / Q000453:epidemiology; D012720:Severity of Illness Index; D012737:Sex Factors; D015912:Thrombolytic Therapy / Q000639:trends*