title: [Impact of gender on in-hospital death in hospitalized patients with acute myocardial infarction].
abstract: OBJECTIVE
  To investigate whether gender is an independent predictor of in-hospital death in hospitalized patients with acute myocardial infarction (AMI).
  
  
  METHODS
  This retrospective study compared baseline characteristics, therapeutic approaches and the occurrence rate of angina pectoris, reinfarction, heart failure and death during hospitalization between 1501 male and 635 female hospitalized patients with AMI. Multivariate logistic regression analysis was performed to identify risk factors predicting in-hospital death.
  
  
  RESULTS
  In-hospital death rate was significantly higher in female than male patients with AMI (11.7% vs. 6.3%, P < 0.01). Female patients with AMI were significantly older than male patients [(67.8 +/- 9.2) years vs. (61.1 +/- 11.9) years, P < 0.01] had a higher incidence of hypertension (52.1% vs. 41.1%, P < 0.01), diabetes mellitus (35.4% vs. 17.3%, P < 0.01), cardiac function > or = Killip class III (11.7% vs. 5.1%, P < 0.01) and TC > 4.68 mmol/L (71.3% vs. 55.0%, P < 0.01). Cigarette smoking, however, was more common in males than in females (69.4% vs. 15.7%, P < 0.01). Reperfusion therapy within the first 24 hours after symptom onset, beta-blockers and statins use during hospitalization were significantly fewer in females compared with males (22.2% vs. 31.5%, P < 0.01; 64.6% vs. 71.2%, P = 0.003; 43.1% vs. 48.0%, P = 0.041, respectively). An increased mortality was demonstrated in females during the hospitalization phase of AMI (11.7% vs. 6.3%, P < 0.01). The results of logistic regression demonstrated that age, diabetes mellitus, hypertension, Killip classification of cardiac function, administration of reperfusion therapy and beta receptor blockers use were significant predictors of in-hospital death in patients with AMI, with odds ratios being 1.06 (95% CI: 1.04 - 1.08), 1.96 (95% CI: 1.32 - 2.90), 1.80 (95% CI: 1.25 - 2.58), 2.86 (95% CI: 2.35 - 3.48), 0.44 (95% CI: 0.30 - 0.66) and 0.51 (95% CI: 0.36 - 0.74), respectively.
  
  
  CONCLUSIONS
  The in-hospital mortality of females is significantly higher than that of males in this patient cohort. Older age, higher risk factor rates, less reperfusion therapy and beta-blockers use contributed to the higher in-hospital mortality in female patients with AMI compared to males.
authors.affiliation: Department of Cardiology, Shandong University Affliated Provincial Hospital, Jinan 250021, China.
authors.forename: Shi-liang
authors.initials: SL
authors.lastname: Jiang
authors.forename: Xiao-ping
authors.initials: XP
authors.lastname: Ji
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiao-rong
authors.initials: XR
authors.lastname: Wang
authors.forename: Mei
authors.initials: M
authors.lastname: Ni
authors.forename: Cheng
authors.initials: C
authors.lastname: Zhang
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors