[Trends in out-of-hospital mortality from ischemic heart disease in Kaunas middle-aged population during 1983-1998].
UNLABELLED: The aim of the study was to evaluate trends in out-of-hospital mortality from ischemic heart disease (IHD) in Kaunas population aged 25-64 years during 1983-1998, according to the ischemic heart disease register data. MATERIALS AND METHODS: The primary source of data was Kaunas population-based ischemic heart disease register. The main sources of information for registration of ischemic heart disease events were hospital discharge records, patient follow-up records of out-of-patient departments, death certificates, necropsy and medico-legal records. The data were collected according to the requirements of the WHO program MONICA. Only deaths from IHD that occurred out-of-hospital were analyzed in this study. The age-standardized rates were calculated by the direct method and the world standard population was used as the standard. Trends in rates were analyzed using the method of linear regression on logarithms of the age-standardized annual mortality rates. RESULTS: During 1983-1998, out-of-hospital IHD mortality was 137.9/100000 among Kaunas men aged 25-64 years meanwhile among women the corresponding rate was 7 times lower (20.2/100000). During 1983-1994, out-of-hospital mortality from IHD was increasing and during 1995 to 1998 was decreasing (by 19.8% per year; p=0.03) among men. Among women, out-of-hospital mortality rates were increasing during 1983-1990, were rather stable during 1991-1994, and tended to decrease by 27.5% per year (p=0.09) during 1995-1998. When analyzing trends in rates by 10-year age groups, statistically significant changes in out-of-hospital mortality from IHD were detected just among those aged 55-64 years. Among men, out-of-hospital mortality from IHD tended to increase during 1983-1994, and was decreasing statistically significantly (by 22.9% per year; p=0.007) during 1995-1998. Among women, the corresponding rates were increasing by 26.7% per year (p=0.03) during 1983-1986, and tended to decrease by 40.1% per year, (p=0.09) during 1995-1998. During 1983-1998, out-of-hospital deaths from IHD accounted on the average for 76.5% among all deaths from IHD among men and for 66.9% among women. During 1983-1998, the proportion of out-of-hospital deaths among all deaths from IHD remained without statistically significant changes among both men and women. CONCLUSION: During 1983-1994, out-of-hospital mortality rates of Kaunas middle-aged men increased and during 1995-1998--significantly decreased. Out-of-hospital mortality rates of Kaunas women increased during 1983-1990, but in 1995-1998--tended to decline. Out-of-hospital deaths from IHD accounted on the average for 76.5% of all deaths from IHD among men and for 66.9% of women deaths, and biggest part of these deaths were among younger persons.