Dados do Trabalho

Título

Mortality due to heart disease as the underlying cause of death after hospital discharge

Resumo

Background Long-term care of patients with heart diseases may be improved based on evaluation of mortality after outpatient visits or in-hospital admission.   Question What is the cause of mortality relative to age, gender, and medical diagnoses.   Goals This study sought to compare the diagnoses made at the first medical visit or hospital admission with the cause of death reported on death certificates.   Methods We reviewed 1,300,000 electronic medical records from 2002 to 2017 from of an academic medical center dedicated to cardiology and pneumology and compared them with mortality data from the State of São Paulo, Brazil (Fundação Sistema Estadual de Análise de Dados - Fundação SEADE). We used deterministic binding to compare the medical records with the mortality data.   Results In the follow-up after the first visit or hospital admission, 148,051 patients had died (median age 71.5 years); 80,161 (54.14%) were male. In 63,319 patients who died due to cardiovascular diseases, the median age was 72.0 years; 34,586 (54.62%) were male. Additional causes of death were found to be neoplasms in 26,514 (17.91%) with median age of 69.2; 14,461 (54.54%) were male; and diseases of the respiratory system in 17,968 (12.14%) with median age of 76.9; 9,581 (53.32%) were male. The Kaplan-Meyer estimated survival rates were similar for patients with ages between 40 and 65 years old and between 65 and 80 years old.   Conclusions Associated to heart diseases, neoplasms and respiratory diseases were significant as causes of mortality of patients during hospitalization or after discharge from an academic medical center in São Paulo, Brazil. Long-term care should be based on the actual cause of illness.

Palavras Chave

survival analysis; epidemiology