Cause of death in Washington state veterans hospitalized with acute coronary syndromes in the veterans health administration
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Date
2008Author
Maynard, Charles
Lowy, Elliott
McDonell, Mary
Fihn, Stephan D.
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Background: In the United States, relatively little is known about cause of death in individuals who die prior to or after hospital discharge for acute coronary syndromes (ACS). The purpose of this
report was to compare baseline patient characteristics according to whether the underlying cause of death was cardiac or non-cardiac.
Methods: We linked cause of death information from Washington State death records to the Department of Veterans Affairs (VA) External Peer Review Program ACS registry. From 524
individuals who were hospitalized for ACS in veterans hospitals located in Washington State or
Oregon, we identified 136 individuals who according to VA death records died during the years
2003 to 2005. Of these, 117 (86%) were found in Washington State death records.
Sociodemographic variables, as well as underlying and secondary causes of death, were obtained
from Washington State death records provided by the Washington State Department of Health.
Clinical variables, including medical histories, presentation on admission, and in-hospital death were
extracted from the VA ACS registry.
Results: Somewhat surprisingly, only 52% of veterans died of cardiac causes when only the
underlying cause of death was used. However, when secondary causes of death were added to the
definition, the proportion that died of cardiac causes increased to 81%. Patient characteristics were
similar in the two groups, although small numbers limited the ability to detect statistically significant
differences.
Conclusion: These preliminary findings suggest that it is important to consider secondary causes
as well as the underlying one when classifying deaths as cardiac or non-cardiac.