[Risk profile in acute myocardial infarction: a necessary assessment for the population's comparisons].
OBJECTIVE
The aim of this study is to show that differences of mortality, in acute myocardial infarction, observed between hospitals are not necessarily linked to a bad application of guidelines but can be linked to differences in the risk profile of the populations.


METHODS
Two populations admitted for ST and non-ST elevation myocardial infarction in the same region in 2006 were compared: the population of Chalon-sur-Saône's hospital with a standard population from the observatoire des Infarctus de Côte d'Or (RICO). The risk profile of the two populations has been realised with the risk scores GRACE, EMMACE and the Simple Risk Index (SRI).


RESULTS
The three scores are applicable for our populations according to the "C statistic". Moreover, there is a significant difference of in-hospital mortality between Chalon-sur-Saône and RICO. But, the population of Chalon-sur-Saône presents a higher risk. Finally, in-hospital rate mortality expected by the three scores is not different from the actual mortality.


CONCLUSIONS
GRACE, EMMACE and SRI are valid scores for the comparison of risk profile of populations in acute myocardial infarction. Comparisons between hospitals are only possible after risk adjustment of the populations.
Fayard
M
M
Service de cardiologie, CHU de Dijon, 2, boulevard Maréchal-de-Lattre-de-Tassigny, 21000 Dijon, France. maximefayard@free.fr
Buttard
P
P
Cusey-Sagnol
I
I
Sagnol
P
P
Salmi-Belmihoub
S
S
Zeller
M
M
Cottin
Y
Y
Dellinger
A
A
D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D044382:Population Groups; D011446:Prospective Studies; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate