Document Detail

Impact of selected geographical and clinical conditions on thrombolysis rate in myocardial infarction in three departments of France.
MedLine Citation:
PMID:  12086084     Owner:  NLM     Status:  MEDLINE    
Our objective was to assess the impact of selected geographic factors and patients' characteristics on thrombolysis rates in patients resident and hospitalised for acute myocardial infarction in three departments of the Rhĵne-Alpes Region (France). We used a two-level hierarchical model to estimate and explain geographic areas' specific effects. Old subjects and women were less frequently treated than young subjects and men. Severe, non-anterior and non-Q-wave myocardial infarctions were associated with lower thrombolysis rates. It was also lower in patients with a pulmonary chronic disease, a cancer, a peripheral arterial disease, a history of cerebrovascular accident or transient ischaemia attack, and in patients with a psychiatric disorder. After adjusting for patients' characteristics, significant variations in thrombolysis rates remained between geographic areas (up to 3.2 times). These variations seem to be partly explained by distance or isolation: a longer distance to the closest hospital or a high degree of isolation seem to lower the probability of thrombolytic therapy. Several other sources of treatment variation between the studied geographic areas remain unexplored. These factors, especially those that augment the delay to treatment, are to be identified in order to augment fibrinolysis usage and reduce inter-area heterogeneity.
M Rabilloud; D Cao; B Riche; F Delahaye; R Ecochard;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of epidemiology     Volume:  17     ISSN:  0393-2990     ISO Abbreviation:  Eur. J. Epidemiol.     Publication Date:  2001  
Date Detail:
Created Date:  2002-06-27     Completed Date:  2002-12-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8508062     Medline TA:  Eur J Epidemiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  685-91     Citation Subset:  IM    
Service de Biostatistique des Hospices Civils de Lyon, France.
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MeSH Terms
Age Factors
Chi-Square Distribution
France / epidemiology
Middle Aged
Myocardial Infarction / epidemiology,  therapy*
Prospective Studies
Regression Analysis
Risk Factors
Thrombolytic Therapy / statistics & numerical data*

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