Epidemiological Characteristics of Acute Coronary Syndrome Patients at Ogulin General Hospital over a Ten-Year Period
Marijana Pavlovic1, Ivana Sovic2, Igor Barkovic3
1Department of Clinical Medical Sciences, Faculty of Health Studies, University of Rijeka, V.C.Emin 5, 51000 Rijeka, Croatia.
Insights
Hospitalizations for ST-elevation myocardial infarction (STEMI) are decreasing, while non-ST-elevation myocardial infarction (NSTEMI) hospitalizations are increasing in Croatia. Age is linked to NSTEMI incidence, highlighting healthcare needs in rural areas.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Cardiovascular diseases, particularly coronary artery disease (CAD), pose a significant public health challenge in Croatia.
- Rural areas may face healthcare disparities due to uneven healthcare facility distribution.
Purpose of the Study:
- To analyze trends in acute coronary syndrome (ACS) hospitalizations over a ten-year period in a rural Croatian hospital.
- To identify demographic and seasonal patterns in ACS incidence.
Main Methods:
- Quantitative, retrospective study of 732 ACS patients treated at Ogulin General Hospital (2014-2023).
- Data extracted from hospital information system; statistical analyses performed (p < 0.05 significance).
Main Results:
- Decreasing trend in ST-elevation myocardial infarction (STEMI) hospitalizations (p < 0.001).
- Increasing trend in non-ST-elevation myocardial infarction (NSTEMI) hospitalizations (p = 0.002).
- Significant association between age and ACS occurrence (p < 0.001); no significant seasonal or gender differences.
Conclusions:
- ACS hospitalization dynamics are changing, with declining STEMI and rising NSTEMI rates.
- Low transfer rates for STEMI patients suggest improved local management.
- NSTEMI incidence increases with age, emphasizing the need for targeted healthcare improvements in rural settings.
Abstract:
Background/Objectives: Cardiovascular diseases remain one of the major public health challenges in Croatia, with coronary artery disease (CAD) as the most prevalent. The uneven development and concentration of healthcare facilities in urban areas suggest that rural regions lag in providing adequate healthcare. Methods: This quantitative, retrospective study included 732 patients diagnosed with acute coronary syndrome (ACS) who were treated between 1 January 2014 and 31 December 2023 at Ogulin General Hospital, Croatia. Data were extracted from the hospital information system, and statistical analyses were performed, with p < 0.05 considered significant. Results: The analysis showed a decreasing trend in hospitalizations of patients with STEMI (Z = -3.574; p < 0.001) and an increase in hospitalizations of patients with NSTEMI (Z = 3.124; p = 0.002). No seasonal (χ2 = 26.33; p = 0.238) or gender differences (χ2 = 3.348; p = 0.188) were observed. A significant association between age and ACS occurrence was observed (χ2 = 57.35; p < 0.001). The proportion of patients transferred to another health institution for further treatment was low (39.21%), particularly among patients with STEMI (12.89%). Conclusions: The results of this study indicate changes in the dynamics of ACS occurrence during the observed ten-year period. The number of hospitalizations is decreasing significantly, with a very low number of transfers of patients with STEMI; at the same time, there is an increase in hospitalizations of patients with NSTEMI. The study did not show statistically significant seasonal or gender differences in the incidence of ACS, while the incidence of NSTEMI increases with the age of the patients. These results emphasize the need for further improvement in the organization of healthcare for patients with ACS in the rural area served by Ogulin General Hospital.
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