epidemiology-2016_scientifictracks-abstracts

16 / 38

Volume 6, Issue 5(Suppl) Epidemiology (Sunnyvale)
ISSN: 2161-1165 ECR, Open Access
Page 49
Notes:
Epidemiology 2016
October 3-5, 2016
conferenceseries.com
Epidemiology & Public HealthOctober 3-5, 2016|London, UK
4th International Conference on
ONE-YEAR SURVIVALAFTER ACUTE MYOCARDIAL INFARCTION (AMI): THE
EFFECT OF CARE-PATHWAY IN ITALY
Belleudi Va, Ventura Ma, Sciattella Pa, Agabiti Na, Di Martino Ma, Di Domenicantonio Ra, Davoli Ma and Fusco Da
aLazio Regional Health Service, Italy
The relationship between guide-lines adherence and outcomes in patients with Acute Myocardial Infarction (AMI) has
been widely investigated considering the phases (emergency, acute, post-acute) of the Care-Pathway (CP) separately. This
research aims to evaluate the effect of the whole AMI-CP on 1-year survival.
We conducted a cohort study, selecting AMI patients from health information systems during 2011-13. Patients’ clinical
history was defined by retrieving previous hospitalizations and drugs prescriptions. For each subject the probability to arrive
in hospital and conditional probabilities to survive to acute and post-acute phases were estimated through multivariate models.
One-year survival probability was calculated as the product of the three probabilities.
Different scenarios of CP quality were defined in terms of emergency-timeliness, hospital performance in treatment of
acute phase and drug therapy in post-acute phase. One-year survival Probability Ratio (PR) and its Bootstrap Confidence
Intervals (BCI) between who effected the best CP and who effected the worst were calculated for a mean-severity patient and
varying sex and age.
We identified 29392 AMI. Out-of-hospital mortality was 27.9%. Among people arrived in hospital, 41.4% had a
hospitalization for STEMI with 11.3% of mortality in acute-phase and 5.6% in post-acute phase. For a patient of mean-severity
the PR was 1.39 (BCI 1.26-1.60). The ratio didn’t change by sex, while it moved from 1.13 (BCI 1.09-1.20) for age 85.
One-year survival probability post AMI depends strongly on CP. Improving performance in the different phases, taking
into account the relationship among these, can lead to considerable savings of lives.
Biography
Valeria Belleudi studied applied mathematics at the University “La Sapienza” of Rome and at University “La Bicocca” of Milan (BSc in 2002, MSc in 2003) and
obtained a Master’s degree in Epidemiology in 2005 from University “La Cattolica” of Rome. In 2003 she started working at the Department of Epidemiology, Lazio
Regional Health Service. She is expert of management and analysis of data from large healthcare databases, she has a strong experience in conducting studies
on chronic diseases, outcomes of care, social inequalities, pharmacoepidemiology and evaluation of care-pathway for acute diseases.
Belleudi V et al., Epidemiology (Sunnyvale), 6:5(Suppl)