Post-Heart Attack Mortality Rate Has Declined Since 1995

Study also finds decrease in the between-hospital variance for 30-day mortality in patients over 65

20 aug 2009 -- The 30-day mortality rate for older patients released from the hospital after acute myocardial infarction has declined since 1995, according to a study in the Aug. 19 issue of the Journal of the American Medical Association.

Harlan M. Krumholz, M.D., of the Yale University School of Medicine in New Haven, Conn., and colleagues examined data on 2,755,370 patients (ages 65 years and older) and 3,195,672 discharges from nonfederal U.S. acute care hospitals from 1995 to 2006. The data was analyzed to determine hospital-level 30-day risk-standardized mortality rates (RSMRs) for patients discharged with acute myocardial infarction.

The researchers found that the 30-day RSMR decreased from 18.8 percent in 1995 to 15.8 percent in 2006. There were also fewer differences in the rates between hospitals, as the between-hospital variance decreased from 4.4 to 2.9 percent and the interquartile range decreased from 2.8 to 2.1 percent.

"Our study reveals a marked reduction in hospital-level 30-day RSMRs in the United States from 1995 through 2006. In this period, the average hospital-specific 30-day RSMR decreased approximately 3 percent, a nearly one-sixth relative reduction in short-term mortality," the authors conclude.

Several study authors reported contractual relationships with the Colorado Foundation for Medical Care, the American College of Cardiology, and the Oklahoma Foundation for Medical Quality. Two co-authors reported membership on a UnitedHealthcare scientific advisory board.

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