[Reduction of XXXX mortality in Chilean hospitals].

@entity1 @entity6 @entity3362 @entity1188 @entity460 @entity583
BACKGROUND: The characteristics of @entity1 with acute @entity583 ( @entity583 ) admitted to 37 Chilean hospitals (GEMI Registry Group), have been analyzed in the period 1993-1995 and 1997-1998. AIM: To report the changes in hospital mortality between these 2 periods, with a particular emphasis on the impact of treatment. @entity1 AND METHODS: Between 1993-1995 we collected information from 2,957 @entity1 and between 1997-1998 we registered 1,981 @entity1 with @entity583 . Analysis of the changes in mortality between periods was adjusted by demographic variables, coronary risk factors, @entity583 location, Killip class on admission and the different therapeutic strategies utilized. The effects of different treatments on hospital mortality were adjusted by the previously determined mortality risk variables. RESULTS: Hospital mortality decreased from 13.3% to 10.8% between both periods (Odds Ratio (OR) 0.78, confidence intervals (95%) (CI) 0.65-0.93). A significant reduction in mortality was observed among @entity1 below 60 years of age, in @entity1 , in @entity6 and in subjects with an @entity1188 classified as Killip class over II. The use of beta blockers (OR 0.65, CI 0.42-0.99) and intravenous @entity3362 (OR 0.78, CI 0.61-0.99) and the lower use of @entity460 channel blockers (OR 0.72, CI 0.60-0.87) were significantly associated with a lower mortality. The administration of angiotensin converting enzyme inhibitors was associated with a 29.3% mortality reduction (OR 0.69, CI 0.47-1.02). CONCLUSIONS: There has been a significant reduction in the mortality rate for @entity583 in Chilean hospitals during the 2 registry periods analyzed, which was significant among some high risk @entity1 and was related to treatment changes, according to evidence based guidelines.
