Improved treatment and prognosis after XXXX in Estonia: cross-sectional study from a high risk country.

@entity1 @entity583
BACKGROUND: The aim of the study was to explore trends in short- and long-term mortality after hospitalization for @entity583 ( @entity583 ) over the period 2001   2011 in Estonian secondary and tertiary care hospitals while adjusting for changes in baseline characteristics. METHODS: In this nationwide cross-sectional study random samples of @entity1 hospitalized due to @entity583 in years 2001, 2007 and 2011 were identified and followed for 1  year. Trends in 30-day and 1-year all-cause mortality were analysed using Cox proportional hazards regression model. RESULTS: The final analysis included 423, 687 and 665 @entity1 in years 2001, 2007 and 2011 respectively. During the study period, the prevalence of most comorbidities remained unchanged while the in-hospital and outpatient treatment improved significantly. For example, the proportion of tertiary care hospital @entity583 @entity1 who underwent revascularization was almost three times higher in 2011 compared to 2001. The proportion of secondary care @entity1 who were referred to a tertiary care centre for more advanced care increased from 5.8 to 40.1  % (p for trend <0.001). Meanwhile, the 1-year mortality rates decreased from 29.5 to 20.2  % (adjusted p   =   0.004) in the tertiary and from 32.4 to 23.1  % (adjusted p   =   0.006) in the secondary care. The decrease in the 30-day mortality rates was statistically significant only in the secondary care hospitals. CONCLUSIONS: The use of evidence-based treatments in @entity583 @entity1 improved between 2001 and 2011. At the same time, we observed a significant reduction in the long-term mortality rates, both for @entity1 primarily hospitalized into secondary as well as into tertiary care hospitals.
