Tendencia en la sobrevida de pacientes hospitalizados por infarto agudo de miocardio según nivel socioeconómico: Chile, 2002-2012

Background: A low socioeconomic status is associated with higher overall mortality rates. Aim: To assess the effect of socioeconomic inequalities on survival of patients hospitalized with a first myocardial infarction. Material and Methods: Analysis of hospital discharge and mortality databases o...

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Autores principales:	Nazzal,Carolina, Alonso,Faustino, Cerecera,Francisco, Ojeda,José Miguel
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2017
Materias:	Chile Myocardial Infarction Social Class Survival Rate
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000700827
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spelling	oai:scielo:S0034-988720170007008272017-11-27Tendencia en la sobrevida de pacientes hospitalizados por infarto agudo de miocardio según nivel socioeconómico: Chile, 2002-2012Nazzal,CarolinaAlonso,FaustinoCerecera,FranciscoOjeda,José Miguel Chile Myocardial Infarction Social Class Survival Rate Background: A low socioeconomic status is associated with higher overall mortality rates. Aim: To assess the effect of socioeconomic inequalities on survival of patients hospitalized with a first myocardial infarction. Material and Methods: Analysis of hospital discharge and mortality databases of the Ministry of Health. Patients aged over 15 years discharged between 2002 and 2011 with a first myocardial infarction (code I-21, ICD-10) were identified. Their survival was verified with the mortality registry. Survival from 0 to 28 and from 29 to 365 days was analyzed. Socioeconomic status was determined using the type of health insurance, stratified as public insurance (low and medium status) and private insurance (high status). Prais-Winsten trend (P-W) and Cox survival analyses were done. Results: We analyzed 59,557 patients (69% males). Sixty three percent were of low socioeconomic status, 19% medium and 18% high. Between 2002 and 2011 the increase in survival was higher among patients of low socioeconomic status, mainly in women (P-W coefficients 0.58:0.31-0.86 in men and 1.12:0.84-1.41 in women for 0-28 days survival and 0.24:0.09-0.39 in men and 0.48:0.37-0.60 in women for 29-365 days survival, respectively). However, age and year of hospitalization adjusted analysis showed a higher mortality risk among patients of low socioeconomic status at 0-28 days (HR 1.67:1.53-1.83 for men and 1.49:1.34-1.66 for women) and at 29-365 days (HR 2.30:1.75-2.71 for men and 1.90:1.56-1.85 for women). Conclusions: Survival after a myocardial infarction improved in the last decade especially in patients of low socioeconomic status. However, subjects of this stratum continue to have a higher mortality.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.145 n.7 20172017-07-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000700827es10.4067/s0034-98872017000700827
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Chile Myocardial Infarction Social Class Survival Rate
spellingShingle	Chile Myocardial Infarction Social Class Survival Rate Nazzal,Carolina Alonso,Faustino Cerecera,Francisco Ojeda,José Miguel Tendencia en la sobrevida de pacientes hospitalizados por infarto agudo de miocardio según nivel socioeconómico: Chile, 2002-2012
description	Background: A low socioeconomic status is associated with higher overall mortality rates. Aim: To assess the effect of socioeconomic inequalities on survival of patients hospitalized with a first myocardial infarction. Material and Methods: Analysis of hospital discharge and mortality databases of the Ministry of Health. Patients aged over 15 years discharged between 2002 and 2011 with a first myocardial infarction (code I-21, ICD-10) were identified. Their survival was verified with the mortality registry. Survival from 0 to 28 and from 29 to 365 days was analyzed. Socioeconomic status was determined using the type of health insurance, stratified as public insurance (low and medium status) and private insurance (high status). Prais-Winsten trend (P-W) and Cox survival analyses were done. Results: We analyzed 59,557 patients (69% males). Sixty three percent were of low socioeconomic status, 19% medium and 18% high. Between 2002 and 2011 the increase in survival was higher among patients of low socioeconomic status, mainly in women (P-W coefficients 0.58:0.31-0.86 in men and 1.12:0.84-1.41 in women for 0-28 days survival and 0.24:0.09-0.39 in men and 0.48:0.37-0.60 in women for 29-365 days survival, respectively). However, age and year of hospitalization adjusted analysis showed a higher mortality risk among patients of low socioeconomic status at 0-28 days (HR 1.67:1.53-1.83 for men and 1.49:1.34-1.66 for women) and at 29-365 days (HR 2.30:1.75-2.71 for men and 1.90:1.56-1.85 for women). Conclusions: Survival after a myocardial infarction improved in the last decade especially in patients of low socioeconomic status. However, subjects of this stratum continue to have a higher mortality.
author	Nazzal,Carolina Alonso,Faustino Cerecera,Francisco Ojeda,José Miguel
author_facet	Nazzal,Carolina Alonso,Faustino Cerecera,Francisco Ojeda,José Miguel
author_sort	Nazzal,Carolina
title	Tendencia en la sobrevida de pacientes hospitalizados por infarto agudo de miocardio según nivel socioeconómico: Chile, 2002-2012
title_short	Tendencia en la sobrevida de pacientes hospitalizados por infarto agudo de miocardio según nivel socioeconómico: Chile, 2002-2012
title_full	Tendencia en la sobrevida de pacientes hospitalizados por infarto agudo de miocardio según nivel socioeconómico: Chile, 2002-2012
title_fullStr	Tendencia en la sobrevida de pacientes hospitalizados por infarto agudo de miocardio según nivel socioeconómico: Chile, 2002-2012
title_full_unstemmed	Tendencia en la sobrevida de pacientes hospitalizados por infarto agudo de miocardio según nivel socioeconómico: Chile, 2002-2012
title_sort	tendencia en la sobrevida de pacientes hospitalizados por infarto agudo de miocardio según nivel socioeconómico: chile, 2002-2012
publisher	Sociedad Médica de Santiago
publishDate	2017
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000700827
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Tendencia en la sobrevida de pacientes hospitalizados por infarto agudo de miocardio según nivel socioeconómico: Chile, 2002-2012

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