Impact on mortality following first acute myocardial infarction of distance between home and hospital: cohort study
2008

Impact of Distance from Home to Hospital on Mortality After First Heart Attack

Sample size: 10541 publication 10 minutes Evidence: moderate

Author Information

Author(s): Wei L, Lang C C, Sullivan F M, Boyle P, Wang J, Pringle S D, MacDonald T M

Primary Institution: Ninewells Hospital and Medical School, Dundee, UK

Hypothesis

Does the distance between home and hospital affect mortality outcomes for patients experiencing an incident myocardial infarction?

Conclusion

The distance between home and hospital of admission may predict mortality in subjects experiencing a first acute MI.

Supporting Evidence

  • 4133 subjects died following incident MI in the community.
  • 6408 patients survived to be hospitalised and 1010 of these died in hospital.
  • 1907 patients died during a median of 3.2 years of follow-up after being discharged.

Takeaway

If you live far from the hospital when you have a heart attack, you might be more likely to die from it. It's better to have hospitals closer to where people live.

Methodology

Cohort study using a record linkage database in Tayside, Scotland.

Potential Biases

Potential underestimation of the benefits of cardiovascular drugs due to assumed compliance.

Limitations

The study did not account for factors like smoking, obesity, and the exact location of heart attacks.

Participant Demographics

Patients were residents of Tayside, Scotland, with a mean age of 77.2 years, including 50.9% women.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI 1.00 to 4.21 for >9 miles and 1.09 to 1.95 for 3–9 miles.

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1136/hrt.2007.123612

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