Long-term prognosis of cardiovascular patients following mobile emergency care.
Mobile emergency care units provide immediate benefit for patients with acute cardiovascular disease, but the subsequent prognosis of this patient population is unclear. We, therefore, aimed to determine whether the long-term survival of patients with acute cardiovascular syndromes requiring emergency medical care differs from controls of the general population. The long-term survival was analysed in all consecutive patients who were treated for acute cardiovascular events (coronary syndromes/cardiac arrest, pulmonary oedema, stroke, vascular disorientation/unconsciousness) by a mobile emergency care unit or rescue helicopter in Berlin from 1987 to 1988 and were admitted to hospital. Subsequent mortality follow-up information was obtained throughout 1994 from medical records and official vital statistics. The survival of the patient population was compared with standardized mortality data of controls matched for gender, age, and residential location. A total of 1206 patients (48% men, 67 +/- 14 years, 52% women, 72 +/- 17 years) were included in the analysis. The 1-year survival of the patient population was significantly lower compared with controls (76% vs. 88%, p < 0.001), but during subsequent years this difference was continuously reduced. Seven years after the initial event, survival rates of patients and controls were similar (43% vs. 41%). The results were similar in both gender groups. Patients > 65 years of age had a markedly higher mortality compared with patients < or = 65 years, as would be expected. Older patients had a similar long-term survival compared with controls (27% vs. 28%), whereas younger patients sustained a relatively lower long-term survival compared with controls (75% vs. 86%, p < 0.05). It is concluded that a novel population-based approach demonstrates similar long-term prognosis of cardiovascular patients following mobile emergency care compared with matched controls. The present results may contribute to the assessment of long-term effectiveness and the appropriate design of emergency care systems.
Willich
S N
SN
Institute for Social Medicine and Epidemiology, Charité Hospital, Humboldt University of Berlin, Germany.
Kulig
M
M
Scholz
R D
RD
Arntz
H R
HR
D000368:Aged; D000552:Ambulances; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis