Determinants of prehospital coronary heart disease death.
    
    
        
    
    
        
        Sci. Rep. 11:17134 (2021)
    
    
    
		
		
			
				Limited data on prehospital and early in-hospital coronary heart disease (CHD) deaths is available. Aims of this study were to provide a comprehensive description on CHD cases and to analyse determinants of prehospital death. From a population-based myocardial infarction (MI) registry in Augsburg, Germany we included 12,572 CHD cases aged 25-74 years between 2003-2017 and 4754 CHD cases aged 75-84 years between 2009-2017. Multivariable logistic regression models were conducted to identify patient characteristics associated with prehospital death compared to 28-day survival. In patients aged 25-74 years, 1713 (13.6%) died prehospital, 941 (7.5%) died within the first 24 h in-hospital and 560 (4.5%) died within the 2nd and 28th day after the acute event; in patients aged 75-84 years the numbers were 1263 (26.6%), 749 (15.8%) and 329 (6.9%), respectively. In both age groups increasing age, actual smoking or nicotine abuse, previous MI, angina pectoris and previous stroke were more likely and hypertension was less likely in cases, who died prehospital compared to 28-day survivors. For example, in the 25-74 years old we revealed an adjusted odds ratio (OR) of 4.53 (95% CI 3.84-5.34) for angina pectoris and an OR of 0.69 (95% CI 0.57-0.85) for hypertension. In cases aged 25-74 years, an association of living alone (OR 1.26, 95% CI 1.06-1.49) and diabetes (OR 1.20, 95% CI 1.03-1.41) with prehospital death was found. Whereas in cases aged 75-84 years, chronic obstructive pulmonary disease (OR 2.20, 95%CI 1.69-0.2.85) was associated with prehospital death. In summary, we observed high prehospital and early in-hospital case fatality. Besides classical cardiac risk factors, the impact of living alone on prehospital death was more important in patients aged 25-74 years than in older patients.
			
			
				
			
		 
		
			
				
					
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        Publikationstyp
        Artikel: Journalartikel
    
 
    
        Dokumenttyp
        Wissenschaftlicher Artikel
    
 
    
        Typ der Hochschulschrift
        
    
 
    
        Herausgeber
        
    
    
        Schlagwörter
        Acute Myocardial-infarction; Sudden Cardiac Death; St-segment Elevation; European-society; Hospital Deaths; Case-fatality; Trends; Mortality; Outcomes; Obesity
    
 
    
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        Sprache
        englisch
    
 
    
        Veröffentlichungsjahr
        2021
    
 
    
        Prepublished im Jahr 
        
    
 
    
        HGF-Berichtsjahr
        2021
    
 
    
    
        ISSN (print) / ISBN
        2045-2322
    
 
    
        e-ISSN
        2045-2322
    
 
    
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	    Band: 11,  
	    Heft: 1,  
	    Seiten: ,  
	    Artikelnummer: 17134 
	    Supplement: ,  
	
    
 
  
        
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            Verlag
            Nature Publishing Group
        
 
        
            Verlagsort
            London
        
 
	
        
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        Begutachtungsstatus
        Peer reviewed
    
 
     
    
        POF Topic(s)
        30202 - Environmental Health
    
 
    
        Forschungsfeld(er)
        Genetics and Epidemiology
    
 
    
        PSP-Element(e)
        G-502900-001
G-504000-006
G-504090-001
    
 
    
        Förderungen
        German Federal Ministry of Health
State of Bavaria
German Research Center for Environmental Health - German Federal Ministry of Education, Science, Research and Technology
Helmholtz Zentrum Munchen
    
 
    
        Copyright
        
    
 	
    
    
    
    
    
        Erfassungsdatum
        2021-09-20