Acute XXXX incidence, mortality and case fatality in Santa Clara, Cuba, 2007-2008.

@entity1 @entity3329 @entity583 @entity204 @entity65
INTRODUCTION: Information on @entity583 incidence and mortality is essential for determining the efficacy of the health system's @entity65 prevention activities; however, in Cuba, sufficient data related to @entity583 are lacking, particularly at the local level. OBJECTIVE: Describe @entity583 incidence, mortality and case fatality rates from January 2007 through December 2008 in @entity1 aged 45-74 in the municipality of Santa Clara, Villa Clara Province, Cuba. METHODS: A retrospective descriptive study was conducted. The World Health Organization MONItoring Trends and Determinants in @entity65 Project (MONICA) methodology was used, but only in part, since out-of-hospital case fatalities were not investigated, resulting in insufficient data for such cases. Cases of @entity583 covered under MONICA definition 1 were included ( @entity3329 , fatal possible, and unclassifiable @entity204 ). Hospitalized @entity1 were followed for 28 days. Incidence, mortality and case fatality rates in the population were calculated by age group (45-54, 55-64 and 65-74 years) and sex. Age-standardized incidence and mortality rates were calculated using the direct method, with the world population as a reference. RESULTS: A total of 482 cases of @entity583 were registered. The percentage of cases of @entity3329 , fatal possible and fatal with insufficient data were 32%, 18.3%, 26.3% and 13.9% respectively. The cumulative age-standardized incidence per 100,000 population was 433 (95% CI 365-501) in @entity1 and 195 (95% CI 152-237) in @entity1 , while mortality per 100,000 population was 242 (95% CI 192-292) in @entity1 and 120 (95% CI 87-153) in @entity1 . Case fatality was 56.4% in @entity1 and 62.6% in @entity1 . Most fatal cases (65.6%) occurred out of hospital, a trend that was more marked in @entity1 (73.9%) than in @entity1 (51%). CONCLUSIONS: Case fatality from @entity583 in Santa Clara residents was high, especially in @entity1 . Two thirds of fatalities occurred out of hospital, a higher proportion of these @entity204 in @entity1 . It is recommended that the AMI registry be completed by investigating out-of-hospital case fatalities with insufficient data; expanding it to include the 35-44 age group; and that the supply of cardiac marker enzyme immunoassay test kits in Santa Clara be stabilized.
