National Trends and Outcomes of Myocardial Infarction: Result from National Inpatient Sample 2000 to 2015

Abstract

The burden of cardiovascular disease within the United States is profound, with large volumes of economic and academic resources being utilized to treat patients with cardiovascular diseases. Myocardial infarctions (MI) represent one of the most acute forms of cardiovascular pathology, with a profound mortality rate if prompt treatment and medical attention is not sought out after. While elements of changes in clinical practice and the spurring of new guidelines are responsible for improved health outcomes within year to year, the appraisal of trends in clinical outcomes allows for the scrutiny of methodology in approaching the patient with MI. Moreover, stratification of outcomes based on variables that have been shown to be associated with differential end outcomes in MI, such as age, sex, and type of institution allow for further partitioning of guidelines to meet more specific and tailored decision making guidelines or algorithms. For our dataset, a sampling of MI discharges between the years of 2000 and 2015 using the National Inpatient Sample (NIS), an open-access all-player database that features data on inpatient statistics represented in hospital admissions within institutions that participate within the NIS. Analyses regarding year-to-year length of stay and mortality outcomes of patients by age, sex, and type of institution was performed, showing a decrease in MI discharges, and a statistically significant difference in mean length of stay time at teaching institutions vs. non-teaching hospitals. These results can be compared with contemporary guidelines to assess whether current clinical practice is equipped to address these differential clinical outcomes. OBSeRvAtiONAl StuDy