Table 2.
Multivariate analysis of the trends in revascularisation procedures and in in-hospital mortality for patients discharged from hospital with a main diagnosis of acute myocardial infarction, Switzerland and Swiss regions, for period 1998–2008
| Switzerland | Leman | Mittelland | Northwest | Zurich | Eastern | Central | Ticino | |
|---|---|---|---|---|---|---|---|---|
| Revascularization procedures |
|
|
|
|
|
|
|
|
| Number of discharges, all |
102,729 |
18,702 |
21,275 |
19,492 |
17,684 |
12,522 |
6,408 |
6,646 |
| ICU |
0.99 (0.98–1.00) |
1.06 (1.05–1.07) |
0.99 (0.98–1.01) |
0.94 (0.93–0.95) |
0.92 (0.91–0.93) |
1.10 (1.08–1.11) |
1.10 (1.08–1.12) |
0.85 (0.83–0.87) |
| Angioplasty |
1.25 (1.24–1.25) |
1.20 (1.19–1.21) |
1.27 (1.25–1.28) |
1.26 (1.24–1.27) |
1.21 (1.19–1.22) |
1.60 (1.55–1.64) |
1.80 (1.72–1.89) |
1.10 (1.08–1.12) |
| Bare stent |
1.11 (1.10–1.12) |
1.14 (1.13–1.15) |
1.08 (1.06–1.10) |
1.06 (1.04–1.08) |
1.07 (1.06–1.08) |
1.31 (1.26–1.36) |
1.62 (1.54–1.69) |
1.05 (1.02–1.07) |
| Drug-eluting stent |
1.66 (1.65–1.68) |
1.59 (1.55–1.64) |
1.54 (1.51–1.58) |
1.52 (1.49–1.56) |
1.96 (1.88–2.03) |
2.14 (2.03–2.26) |
2.97 (2.54–3.46) |
2.58 (2.38–2.80) |
| CABG |
1.08 (1.06–1.09) |
1.06 (1.03–1.09) |
1.19 (1.15–1.23) |
1.07 (1.03–1.10) |
1.03 (1.00–1.06) |
1.71 (1.25–2.33) |
DNC |
1.02 (0.98–1.06) |
| Circulatory assistance |
1.17 (1.14–1.19) |
1.10 (1.06–1.14) |
1.27 (1.20–1.35) |
1.24 (1.15–1.33) |
1.13 (1.10–1.17) |
2.09 (1.59–2.74) |
1.92 (1.45–2.54) |
1.02 (0.88–1.19) |
| Thrombolysis |
1.00 (0.99–1.02) |
1.02 (1.00–1.05) |
0.99 (0.97–1.02) |
0.92 (0.88–0.95) |
1.06 (1.03–1.08) |
1.09 (1.04–1.14) |
0.96 (0.90–1.02) |
0.91 (0.87–0.95) |
| In-hospital mortality |
|
|
|
|
|
|
|
|
| Number of discharges § |
73,764 |
13,301 |
13,905 |
14,143 |
13,338 |
10,132 |
4,826 |
4,119 |
| Seven-day mortality |
1.00 (0.99–1.01) |
1.00 (0.98–1.02) |
1.02 (1.00–1.04) |
0.99 (0.97–1.01) |
0.99 (0.97–1.01) |
0.99 (0.96–1.01) |
1.03 (0.99–1.06) |
1.02 (0.98–1.06) |
| Overall mortality |
1.00 (0.99–1.01) |
1.00 (0.98–1.02) |
1.02 (1.00–1.04) |
1.00 (0.98–1.02) |
0.99 (0.97–1.01) |
0.98 (0.96–0.99) |
1.03 (1.00–1.06) |
1.02 (0.99–1.06) |
| Number of discharges §§ |
62,021 |
11,417 |
11,371 |
11,853 |
11,798 |
8756 |
4152 |
2674 |
| Seven-day mortality |
1.01 (1.00–1.02) |
1.00 (0.98–1.03) |
1.03 (1.01–1.05) |
1.00 (0.97–1.02) |
1.00 (0.98–1.02) |
0.99 (0.97–1.02) |
1.05 (1.01–1.09) |
DNC |
| Overall mortality | 1.01 (1.00–1.02) | 1.01 (0.99–1.03) | 1.03 (1.01–1.05) | 1.01 (0.99–1.03) | 1.00 (0.98–1.01) | 0.99 (0.96–1.01) | 1.04 (1.01–1.08) | 1.03 (0.99–1.07) |
Results are expressed as multivariate adjusted Odds ratio and (95% confidence interval) for a one-year increase. ICU intensive care unit; CABG coronary artery bypass graft; DNC model did not converge. Statistical analysis by multivariate logistic regression. For revascularization procedures, analysis was conducted adjusting for age (continuous), gender and transfer type (in-house, inbound, outbound and passing through) for each Swiss region; for Switzerland, a further adjustment was performed on region. For in-hospital mortality, analysis was conducted adjusting for age (continuous), gender, ICU stay (yes/no), hemodynamic assistance (yes/no) and revascularization procedures (yes/no code: bare stent, drug eluting stent and CABG) for each Swiss region; for Switzerland, a further adjustment was performed on region. §, patients not transferred to another hospital (inboud or in-house); §§, patients managed in a single hospital (in-house).