Original scientific paper
Specific and Gender Differences between Hospitalized and out of Hospital Mortality due to Myocardial Infarction
Lina Mirić
Dinko Mirić
Darko Duplančić
Slaven Kokić
Dragan Ljutić
Valdi Pešutić
Viktor Čulić
Damir Fabijanić
Marina Titlić
Abstract
In this paper, the authors evaluate gender related differences of myocardial infarction mortality before and after hospital
admittance. Myocardial infarction mortality in the Clinical Hospital Split in the seven years period between 2000
and 2006, have been analyzed together with out of hospital sudden death patients with acute myocardial infarction established
during autopsy. During the seven year period between 2000 and 2006, 3434 patients were treated for myocardial
infarction in the Split Clinical Hospital, 2336 (68%) males and 1098 (32%) females with a 12% total mortality (427
patients). The annual number of hospitalized persons has been increasing during that period (474 in yr. 2000 vs. 547 in
yr. 2006), while mortality decreased from 15% in 2000 to 9.6% in 2006. Female patients had significantly higher hospital
mortality than male patients, (228 or 21% vs. 202 or 9%, p<0.05). Women also had significantly higher total AMI mortality
(23.7% vs. 15,7%, p<0.05). Anterior myocardial infarction with ST elevation in precordial leads had significantly
higher mortality (19%) compared to patients with lateral (11%), inferior (10%) myocardial infarction with ST elevation
and also NSTEMI (4%) mortality p<0.05. Female patients more frequently die in hospital, 84% (230) than out of hospital
16% (43). From the total number of AMI deaths (388) in male patients, 56% (217) were in hospital and 44% (171) out
of hospital (p<0.001). Men had significantly higher prehospital mortality rate than women (81% vs. 19%, p<0.05). Men
also more frequently died from ventricular fibrillation (22% vs. 10%, p<0.05), while women died more frequently of
heart failure, cardiogenic shock, and myocardial rupture (33% vs. 15% p<0.05). Regarding the total number of deaths
from myocardial infarction men had significantly higher prehospital mortality compared to women (178 or 7.3% vs. 43
or 3.7%, p<0.05). Anterior myocardial infarction had a significantly higher rate in patients dying pre-hospital (58%), in
contrast to inferior (36%) and lateral myocardial infarction with ST elevation (6%) p<0,05.We have concluded that male
patients die more frequently within the first few hours of AMI mostly due to malignant arrhythmias, while female patients
died in sub acute stage due to heart failure while being hospitalized. Nevertheless total mortality of AMI remains
significantly higher in women.
Keywords
myocardial infarction; mortality; gender
Hrčak ID:
27209
URI
Publication date:
7.7.2008.
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