title: Age- and sex-specific in-hospital mortality after myocardial infarction in routine clinical practice.
abstract: Background. Literature regarding the influence of age/sex on mortality trends for acute myocardial infarction (AMI) hospitalizations is limited to hospitals participating in voluntary AMI registries. Objective. Evaluate the impact of age and sex on in-hospital AMI mortality using a nationally representative hospital sample. Methods. Secondary data analysis using AMI hospitalizations identified from the Nationwide-Inpatient-Sample (NIS). Descriptive and Cox proportional hazards analysis explored mortality trends by age and sex from 1997-2006 while adjusting for the influence of, demographics, co-morbidity, length of hospital stay and hospital characteristics. Results. From 1997-2006, in-hospital AMI mortality rates decreased across time in all subgroups (P < .001), except for males aged <55 years. The greatest decline was observed in females aged <55 years, compared to similarly aged males, mortality outcomes were poorer in 1997-1998 (RR 1.47, 95% CI  =  1.30-1.66), when compared with 2005-2006 (RR 1.03, 95% CI  =  0.90-1.18), adjusted P value for trend demonstrated a statistically significant decline in the relative AMI mortality risk for females when compared with males (<0.001). Conclusion. Over the last decade, in-hospital AMI mortality rates declined for every age/sex group except males <55 years. While AMI female-male mortality disparity has narrowed, some room for improvement remains.
authors.affiliation: Department of Family Medicine, Charles Drew University of Medicine and Science, Los Angeles, CA 90059-2518, USA.
authors.forename: Chizobam
authors.initials: C
authors.lastname: Ani
authors.forename: Deyu
authors.initials: D
authors.lastname: Pan
authors.forename: David
authors.initials: D
authors.lastname: Martins
authors.forename: Bruce
authors.initials: B
authors.lastname: Ovbiagele