Article
Risk and resilience factors determining survival time after myocardial infarct
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Published: | September 26, 2017 |
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Outline
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Background: Chronic diseases account for a substantial amount in annual medical expenditures. One such disease characterised by high levels of mortality is coronary heart disease (CHD; Pagidipati and Gaziano, 2013); the majority of CHD related-deaths being linked to myocardial infarct. Structured health programs such as disease-management-programs (DMPs) targeting CHD aim specifically at reducing mortality.
Aim: Here, we aim at investigating risk and resilience factors that impact on survival time after myocardial infarct using DMP-generated health records in a subsample of CHD patients.
Methods: We use data from 1402 patients suffering from coronary heart disease who have experienced a myocardial infarct and participate in CHD-DMPs in North Rhine-Westphalia in Germany (total of N=242.931 patients). Survival analyses using Kaplan-Meier estimators were employed to determine factors influencing post-myocardial infarct survival time; estimation was evaluated using log rank tests.
Results: Preliminary results showed trend-level significant differences in post-myocardial infarct survival times for CHD patients for the length of stay within the CHD disease-management-program (<= 11.5 vs. > 11.5 years in CHD-DMP): chi2(1)=3.605, p=.058.
Discussion: We present tentative evidence indicating beneficial effects of structured health programs such as disease-management-programs to survival times after myocardial infarct. These analyses will be extended to include known pre-existing factors as priors into survival analyses.
Implications: Our findings aim to elucidate on risk and resilience factors that impact on survival time after myocardial infarct. These findings can impact on the way CHD care is delivered and thereby help to reduce myocardial infarct linked mortality.