Trends and disparities in the location of mortality from myocardial infarction: A 21-year retrospective analysis.

Abstract

Background: Despite noteworthy developments and advancements in the field of cardiovascular medicine, myocardial infarction (MI) remains one of the leading causes of mortality worldwide.

Aim: To investigate the existence of disparities within MI-related locations of deaths in the United States.

Methods: Data on death certificates from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER) was utilized to evaluate trends in the locations of MI-related mortality from 1999 to 2020. The following locations were considered: (i) inpatient facilities, (ii) outpatient/emergency facilities, (iii) decedent's home, and (iv) nursing or hospice facilities.

Results: A total of 2858,426 MI-related deaths were utilized in this analysis. A steady decline in inpatient mortality was noted, along with a consistent increase in outpatient or emergency room (E.R.) mortality. The male sex was less likely to die in nursing or hospice facilities (OR: 0.44; P < 0.05). Younger individuals (<45 years) were more likely to die in outpatient/E.R. facilities (OR: 5.92; P < 0.05), whereas the elderly (85+ years) were more susceptible to nursing or hospice facilities. Non-Hispanic Black individuals were prone to death in outpatient/E.R. facilities (OR: 1.42; P < 0.05), whereas Non-Hispanic White individuals were more likely to die in nursing or hospice facilities. Additionally, rural areas had a higher risk of death at home (OR: 1.55; P < 0.05), whereas urban areas were more inclined towards inpatient mortality.

Conclusions: This analysis identified several disparities and higher risk populations, emphasizing the need for better outreach to deliver practical management strategies in an equitable fashion.