doi:10.4061/2010/752765 Clinical Study Age- and Sex-Specific In-Hospital Mortality after Myocardial Infarction in Routine Clinical Practice

Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Literature regarding the influence of age/sex on mortality trends for acute myocardial infarction (AMI) hospitaliza-tions 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 rate