IN-HOSPITAL MORTALITY AFTER ACUTE MYOCARDIAL-INFARCTION IN ELDERLY MEN AND WOMEN

Objectives The proportion of women suffering and dying from acute myoc ardial infarction (AMI) increases steadily with advancing age, There i s persisting uncertainty whether women have greater in-hospital mortal ity after AMI than do men, The aim of our study was to evaluate the im portance of female gender as a risk factor for in-hospital mortality f ollowing AMI in elderly patients. Design This retrospective cohort stu dy was carried out in San Giovanni Hospital in Turin. Seven hundred an d twenty-four patients (429 men, 295 women) aged 65 years or more (mea n 74.0 +/- 6.3 years) who were consecutively admitted to hospital with validated primary discharge diagnosis of AMI in the period 1988-1991 were studied, Multivariate models of analysis were used to evaluate th e independent predictive value of female sex for in-hospital mortality and to identify sex-related variables accounting for the greater mort ality rates observed in women. Results In-hospital mortality was signi ficantly greater in women than in men (34.6% compared with 25.6%, P < 0.01). After multivariate adjustment, female sex was not independently predictive for in-hospital mortality Low (< 12 g/dl) haemoglobin leve ls, development of cardiac failure and major rhythm disorders during h ospital stay, and different therapeutic procedures were the variables which appeared to account for the greater mortality observed in women. Conclusions Despite the absence of an independent adverse effect of f emale sex, elderly women who develop AMI appear to be at greater risk for in-hospital mortality Chronic anaemia, particular susceptibility t o severe complications during hospital stay and differences in therape utic procedures appear to account for much of this greater risk. (C) R apid Science Publishers.