Table 1 The baseline characteristics of the study population by study year
From: Temporal trends in healthcare resource utilization and costs following acute myocardial infarction
Year | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | p for trend |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | 426 | 1233 | 1822 | 2491 | 3111 | 3695 | 4211 | 4664 | 5067 | 5482 | 5650 | 5223 | 2115 | |
Demographics | ||||||||||||||
 Age at AMI, years; Mean (SD) | 64.20 (12.97) | 64.09 (12.96) | 63.76 (12.88) | 63.40 (12.84) | 63.06 (12.72) | 63.02 (12.88) | 62.68 (12.94) | 62.44 (12.93) | 62.23 (12.95) | 62.09 (13.00) | 61.99 (13.01) | 61.78 (12.97) | 60.79 (12.74) | < 0.001 |
 Sex, Male | 293 (68.8) | 850 (68.9) | 1278 (70.1) | 1761 (70.7) | 2235 (71.8) | 2662 (72.0) | 3068 (72.9) | 3404 (73.0) | 3717 (73.4) | 4013 (73.2) | 4165 (73.7) | 3886 (74.4) | 1579 (74.7) | < 0.001 |
 Muslims | 85 (20.0) | 246 (20.0) | 371 (20.4) | 508 (20.4) | 642 (20.6) | 774 (20.9) | 910 (21.6) | 1056 (22.6) | 1180 (23.3) | 1306 (23.8) | 1367 (24.2) | 1310 (25.1) | 515 (24.3) | < 0.001 |
Cardiac diseases | ||||||||||||||
 Supraventricular arrhythmias | 46 (10.8) | 159 (12.9) | 221 (12.1) | 306 (12.3) | 373 (12.0) | 456 (12.3) | 497 (11.8) | 540 (11.6) | 570 (11.2) | 616 (11.2) | 645 (11.4) | 577 (11.0) | 223 (10.5) | 0.003 |
 CHF | 80 (18.8) | 186 (15.1) | 261 (14.3) | 341 (13.7) | 390 (12.5) | 450 (12.2) | 499 (11.8) | 525 (11.3) | 533 (10.5) | 554 (10.1) | 555 (9.8) | 486 (9.3) | 172 (8.1) | < 0.001 |
 Pulmonary heart disease | 13 (3.1) | 56 (4.5) | 88 (4.8) | 140 (5.6) | 162 (5.2) | 214 (5.8) | 241 (5.7) | 282 (6.0) | 307 (6.1) | 314 (5.7) | 349 (6.2) | 308 (5.9) | 109 (5.2) | 0.012 |
 CIHD | 305 (71.6) | 932 (75.6) | 1407 (77.2) | 1928 (77.4) | 2458 (79.0) | 2951 (79.9) | 3426 (81.4) | 3860 (82.8) | 4205 (83.0) | 4565 (83.3) | 4761 (84.3) | 4447 (85.1) | 1820 (86.1) | < 0.001 |
 AV block | 14 (3.3) | 42 (3.4) | 68 (3.7) | 92 (3.7) | 111 (3.6) | 118 (3.2) | 129 (3.1) | 148 (3.2) | 159 (3.1) | 177 (3.2) | 183 (3.2) | 161 (3.1) | 63 (3.0) | 0.092 |
Cardiovascular risk factors | ||||||||||||||
 Renal diseases | 206 (48.4) | 479 (38.8) | 640 (35.1) | 844 (33.9) | 1001 (32.2) | 1125 (30.4) | 1244 (29.5) | 1335 (28.6) | 1416 (27.9) | 1499 (27.3) | 1447 (25.6) | 1296 (24.8) | 504 (23.8) | < 0.001 |
 Diabetes Mellitus | 157 (36.9) | 409 (33.2) | 598 (32.8) | 801 (32.2) | 1028 (33.0) | 1250 (33.8) | 1416 (33.6) | 1536 (32.9) | 1678 (33.1) | 1802 (32.9) | 1908 (33.8) | 1770 (33.9) | 681 (32.2) | 0.825 |
 Dyslipidemia | 291 (68.3) | 815 (66.1) | 1236 (67.8) | 1671 (67.1) | 2140 (68.8) | 2555 (69.1) | 2969 (70.5) | 3331 (71.4) | 3680 (72.6) | 4006 (73.1) | 4170 (73.8) | 3871 (74.1) | 1563 (73.9) | < 0.001 |
 Hypertension | 200 (46.9) | 648 (52.6) | 929 (51.0) | 1252 (50.3) | 1556 (50.0) | 1872 (50.7) | 2114 (50.2) | 2368 (50.8) | 2575 (50.8) | 2796 (51.0) | 2921 (51.7) | 2670 (51.1) | 1074 (50.8) | 0.253 |
 Obesity | 87 (20.4) | 255 (20.7) | 369 (20.3) | 535 (21.5) | 683 (22.0) | 849 (23.0) | 1001 (23.8) | 1145 (24.5) | 1254 (24.7) | 1368 (25.0) | 1414 (25.0) | 1302 (24.9) | 553 (26.1) | < 0.001 |
 Smoking | 168 (39.4) | 487 (39.5) | 770 (42.3) | 1064 (42.7) | 1359 (43.7) | 1617 (43.8) | 1896 (45.0) | 2110 (45.2) | 2313 (45.6) | 2524 (46.0) | 2616 (46.3) | 2451 (46.9) | 1030 (48.7) | < 0.001 |
 PVD | 58 (13.6) | 165 (13.4) | 245 (13.4) | 305 (12.2) | 365 (11.7) | 411 (11.1) | 444 (10.5) | 471 (10.1) | 492 (9.7) | 501 (9.1) | 472 (8.4) | 416 (8.0) | 164 (7.8) | < 0.001 |
 Family history of IHD | 18 (4.2) | 60 (4.9) | 109 (6.0) | 169 (6.8) | 225 (7.2) | 292 (7.9) | 351 (8.3) | 419 (9.0) | 469 (9.3) | 512 (9.3) | 543 (9.6) | 531 (10.2) | 237 (11.2) | < 0.001 |
Other disorders | ||||||||||||||
 COPD | 20 (4.7) | 79 (6.4) | 121 (6.6) | 155 (6.2) | 182 (5.9) | 206 (5.6) | 220 (5.2) | 239 (5.1) | 247 (4.9) | 261 (4.8) | 273 (4.8) | 235 (4.5) | 87 (4.1) | < 0.001 |
 Neurological disorders | 47 (11.0) | 139 (11.3) | 207 (11.4) | 277 (11.1) | 321 (10.3) | 399 (10.8) | 465 (11.0) | 508 (10.9) | 570 (11.2) | 623 (11.4) | 640 (11.3) | 563 (10.8) | 210 (9.9) | 0.841 |
 Anemia | 199 (46.7) | 576 (46.7) | 836 (45.9) | 1140 (45.8) | 1414 (45.5) | 1737 (47.0) | 1975 (46.9) | 2215 (47.5) | 2409 (47.5) | 2578 (47.0) | 2670 (47.3) | 2440 (46.7) | 944 (44.6) | 0.530 |
 GI bleeding | 6 (1.4) | 20 (1.6) | 35 (1.9) | 48 (1.9) | 60 (1.9) | 61 (1.7) | 73 (1.7) | 78 (1.7) | 84 (1.7) | 94 (1.7) | 97 (1.7) | 84 (1.6) | 35 (1.7) | 0.391 |
 Schizophrenia/Psychosis | 5 (1.2) | 18 (1.5) | 22 (1.2) | 40 (1.6) | 50 (1.6) | 59 (1.6) | 59 (1.4) | 62 (1.3) | 63 (1.2) | 62 (1.1) | 65 (1.2) | 54 (1.0) | 17 (0.8) | 0.001 |
 Alcohol/drug addiction | 9 (2.1) | 20 (1.6) | 30 (1.6) | 48 (1.9) | 67 (2.2) | 76 (2.1) | 79 (1.9) | 90 (1.9) | 96 (1.9) | 106 (1.9) | 105 (1.9) | 97 (1.9) | 37 (1.7) | 0.743 |
 Malignancy | 8 (1.9) | 34 (2.8) | 45 (2.5) | 56 (2.2) | 69 (2.2) | 87 (2.4) | 97 (2.3) | 98 (2.1) | 106 (2.1) | 119 (2.2) | 128 (2.3) | 121 (2.3) | 43 (2.0) | 0.430 |
Administrative characteristics of the hospitalization | ||||||||||||||
 Admitted/transposed to ICCU | 288 (67.6) | 869 (70.5) | 1339 (73.5) | 1848 (74.2) | 2352 (75.6) | 2797 (75.7) | 3233 (76.8) | 3635 (77.9) | 3963 (78.2) | 4264 (77.8) | 4401 (77.9) | 4101 (78.5) | 1707 (80.7) | < 0.001 |
 Length of hospital stay (days), > 7 | 232 (54.5) | 666 (54.0) | 986 (54.1) | 1375 (55.2) | 1668 (53.6) | 1924 (52.1) | 2127 (50.5) | 2308 (49.5) | 2439 (48.1) | 2594 (47.3) | 2599 (46.0) | 2339 (44.8) | 909 (43.0) | < 0.001 |
 Type of AMI, STEMI | 323 (75.8) | 816 (66.2) | 1188 (65.2) | 1531 (61.5) | 1826 (58.7) | 2087 (56.5) | 2331 (55.4) | 2545 (54.6) | 2750 (54.3) | 2961 (54.0) | 2966 (52.5) | 2722 (52.1) | 1130 (53.4) | < 0.001 |
Results of echocardiography | ||||||||||||||
Echocardiography performance | 328 (77.0) | 974 (79.0) | 1482 (81.3) | 2054 (82.5) | 2620 (84.2) | 3117 (84.4) | 3606 (85.6) | 4043 (86.7) | 4421 (87.3) | 4784 (87.3) | 4945 (87.5) | 4624 (88.5) | 1904 (90.0) | < 0.001 |
 Severe LV dysfunction | 31 (9.5) | 91 (9.3) | 135 (9.1) | 176 (8.6) | 210 (8.0) | 234 (7.5) | 244 (6.8) | 264 (6.5) | 291 (6.6) | 332 (6.9) | 358 (7.2) | 346 (7.5) | 117 (6.1) | < 0.001 |
 LV hypertrophy | 24 (7.3) | 52 (5.3) | 67 (4.5) | 84 (4.1) | 102 (3.9) | 125 (4.0) | 143 (4.0) | 150 (3.7) | 143 (3.2) | 163 (3.4) | 162 (3.3) | 146 (3.2) | 65 (3.4) | < 0.001 |
 Mitral regurgitation | 13 (4.0) | 37 (3.8) | 61 (4.1) | 82 (4.0) | 100 (3.8) | 113 (3.6) | 144 (4.0) | 169 (4.2) | 200 (4.5) | 222 (4.6) | 211 (4.3) | 176 (3.8) | 61 (3.2) | 0.717 |
 Tricuspidal regurgitation | 8 (2.4) | 19 (2.0) | 31 (2.1) | 44 (2.1) | 53 (2.0) | 73 (2.3) | 80 (2.2) | 90 (2.2) | 100 (2.3) | 115 (2.4) | 118 (2.4) | 100 (2.2) | 39 (2.0) | 0.571 |
Pulmonary hypertension | 13 (4.0) | 37 (3.8) | 59 (4.0) | 91 (4.4) | 119 (4.5) | 159 (5.1) | 182 (5.0) | 211 (5.2) | 225 (5.1) | 234 (4.9) | 247 (5.0) | 211 (4.6) | 78 (4.1) | 0.418 |
Results of angiography | ||||||||||||||
Angiography performance | 238 (55.9) | 795 (64.5) | 1260 (69.2) | 1731 (69.5) | 2250 (72.3) | 2749 (74.4) | 3225 (76.6) | 3666 (78.6) | 4039 (79.7) | 4418 (80.6) | 4646 (82.2) | 4362 (83.5) | 1774 (83.9) | < 0.001 |
 Measure of CAD, No or non-significant | 7 (2.9) | 42 (5.3) | 62 (4.9) | 85 (4.9) | 105 (4.7) | 125 (4.5) | 150 (4.7) | 173 (4.7) | 196 (4.9) | 215 (4.9) | 240 (5.2) | 216 (5.0) | 75 (4.2) | < 0.001 |
 One vessel | 50 (21.0) | 177 (22.3) | 279 (22.1) | 412 (23.8) | 554 (24.6) | 705 (25.6) | 832 (25.8) | 958 (26.1) | 1083 (26.8) | 1205 (27.3) | 1277 (27.5) | 1236 (28.3) | 534 (30.1) | < 0.001 < 0.001 |
 Two vessels | 71 (29.8) | 221 (27.8) | 358 (28.4) | 496 (28.7) | 653 (29.0) | 788 (28.7) | 902 (28.0) | 1041 (28.4) | 1143 (28.3) | 1255 (28.4) | 1325 (28.5) | 1262 (28.9) | 506 (28.5) | |
 Three vessels/ LM | 110 (46.2) | 355 (44.7) | 561 (44.5) | 738 (42.6) | 938 (41.7) | 1130 (41.1) | 1340 (41.6) | 1494 (40.8) | 1617 (40.0) | 1743 (39.5) | 1804 (38.8) | 1648 (37.8) | 659 (37.1) | |
 Type of treatment, Noninvasive | 179 (42.0) | 418 (33.9) | 533 (29.3) | 687 (27.6) | 770 (24.8) | 841 (22.8) | 868 (20.6) | 862 (18.5) | 879 (17.3) | 899 (16.4) | 833 (14.7) | 691 (13.2) | 258 (12.2) | |
 PCI | 203 (47.7) | 673 (54.6) | 1070 (58.7) | 1506 (60.5) | 1960 (63.0) | 2360 (63.9) | 2725 (64.7) | 3079 (66.0) | 3391 (66.9) | 3707 (67.6) | 3908 (69.2) | 3669 (70.2) | 1512 (71.5) | < 0.001 |
 CABG | 44 (10.3) | 142 (11.5) | 219 (12.0) | 298 (12.0) | 381 (12.2) | 494 (13.4) | 618 (14.7) | 723 (15.5) | 797 (15.7) | 875 (16.0) | 908 (16.1) | 862 (16.5) | 345 (16.3) | |
Healthcare utilization an year before AMI; Mean (SD) | ||||||||||||||
 Hospitalizations LOS, days | 4.28 (7.74) | 4.61 (9.79) | 4.47 (10.45) | 4.38 (9.81) | 4.1 (8.49) | 4.04 (8.47) | 3.73 (7.79) | 3.59 (7.49) | 3.49 (8.34) | 3.27 (8.02) | 3.03 (7.90) | 2.8 (7.76) | 2.82 (8.27) | < 0.001 |
 Number of ED visits | 0.02 (0.17) | 0.03 (0.20) | 0.03 (0.20) | 0.03 (0.19) | 0.02 (0.19) | 0.02 (0.17) | 0.02 (0.17) | 0.03 (0.20) | 0.06 (0.32) | 0.11 (0.52) | 0.13 (0.49) | 0.16 (0.55) | 0.12 (0.47) | < 0.001 |
 Number of primary clinic visits | 3.01 (5.50) | 6.97 (8.45) | 8.20 (9.04) | 9.11 (9.45) | 9.65 (9.85) | 10.03 (10.06) | 10.23 (10.12) | 10.37 (10.14) | 10.48 (10.2) | 10.50 (10.16) | 10.72 (9.97) | 10.76 (9.91) | 10.41 (9.90) | < 0.001 |
 Number of ambulatory clinic visits | 5.18 (8.52) | 5.15 (10.64) | 3.83 (8.60) | 4.79 (10.86) | 5.39 (12.00) | 5.92 (12.39) | 6.12 (12.00) | 6.59 (14.07) | 6.86 (14.96) | 6.83 (14.51) | 6.64 (13.27) | 6.70 (13.08) | 6.61 (12.45) | < 0.001 |
 Number of consulting clinic visits | 0.53 (1.25) | 0.78 (1.68) | 0.82 (1.70) | 0.93 (1.85) | 0.94 (1.83) | 0.97 (1.81) | 0.98 (1.83) | 1.02 (1.92) | 1.03 (1.92) | 1.04 (1.95) | 1.06 (1.96) | 1.06 (1.93) | 1.05 (2.02) | < 0.001 |
 Total cost, USD | 2391 (4029) | 2962 (5066) | 2909 (4878) | 3055 (5516) | 3090 (5457) | 3136 (5458) | 3043 (4819) | 3109 (5231) | 3208 (6453) | 3124 (6182) | 3006 (5675) | 2922 (5585) | 2966 (6618) | 0.996 |
Follow-up | ||||||||||||||
 Full adherence to medical treatment during the 1st year | 64 (15.0) | 218 (17.7) | 362 (19.9) | 553 (22.2) | 724 (23.3) | 888 (24.0) | 1065 (25.3) | 1204 (25.8) | 1293 (25.5) | 1354 (24.7) | 1378 (24.4) | 1275 (24.4) | 529 (25.0) | < 0.001 |
 Age in the present year, years; Mean (SD) | 64.20 (12.97) | 64.74 (12.95) | 65.00 (12.88) | 65.11 (12.84) | 65.23 (12.71) | 65.64 (12.82) | 65.77 (12.88) | 66.00 (12.85) | 66.27 (12.84) | 66.55 (12.83) | 66.65 (12.83) | 66.69 (12.86) | 67.40 (12.64) | < 0.001 |
 Period since AMI, years; Mean (SD) | 1.00 (0) | 1.33 (0.47) | 1.85 (0.74) | 2.28 (1.05) | 2.71 (1.34) | 3.16 (1.62) | 3.61 (1.90) | 4.08 (2.17) | 4.56 (2.44) | 4.97 (2.74) | 5.14 (2.87) | 5.37 (2.75) | 6.68 (2.53) | < 0.001 |