Regionalne razlike u standardiziranim stopama mortaliteta od akutnog i ponovljenog infarkta miokarda u Republici Hrvatskoj od 2015. do 2019. godine

Zrinka Biloglav, Matea Turudić , Dominic Vidović, Petar Medaković, Blanka Glavaš, Ivan Padjen, Antun Tonko Jakobović, Nikolina Jupek, Stipe Radoš, Iva Karla Crnogorac, Ivana Škrlec, Joško Bulum

Cilj rada: Cilj istraživanja jest utvrditi opću i dobno-specifičnu stopu smrtnosti za akutni i ponavljajući infarkt miokarda (IM) po hrvatskim županijama za razdoblje od 2015. do 2019. godine, koristeći revidiranu europsku populaciju iz 2013. godine (RESP). Dodatni je cilj usporediti utvrđene stope s prosječnim stopama za Hrvatsku i EU, kao i istražiti povezanost između stopa i makroekonomskih pokazatelja. Materijal i metode: Izračunate su opće i dobno standardizirane stope mortaliteta za akutni i ponovljeni IM koristeći RESP kao i njegovu stariju verziju, europsku standardnu populaciju iz 1976. godine (ESP). Dobno standardizirane stope uspoređene su s prosječnom stopom u Hrvatskoj (2017. godine) i EU (2019. godine). Prosječna stopa smrtnosti u EU temeljena je na RESP-u i dobivena je iz baze Eurostat. Broj umrlih dobiven je od Hrvatskog zavoda za javno zdravstvo, a popis stanovnika iz Državnog zavoda za statistiku. Analizirana je povezanost stopa mortaliteta i dvaju indikatora: bruto domaćeg proizvoda (BDP) i indeksa gospodarske snage Hrvatske gospodarske komore. Rezultati: Opće stope mortaliteta za akutni i ponovljeni IM iznosi od 72 do 91 (na 100.000 stanovnika), s velikim rasponom između županija od 35 do 120. Dobno standardizirane stope temeljene na RESP-u za većinu županija brojčano su više spram stopa temeljenih na ESP-u. U svim županijama dobno standardizirane stope nadilaze prosjek EU-a (do tri puta), a smrtnost u kontinentalnim županijama viša je od smrtnosti u obalnim županijama. Dok indeks HGK-a ne korelira značajno sa smrtnošću, BDP negativno korelira u muškaraca (r = -0.492, p = 0,023). Zaključci: Primjena RESP-a umjesto ESP-a preduvjet je za usporedbu dobno standardiziranih stopa smrtnosti s članicama EU-a. Usprkos međužupanijskim razlikama, stope smrtnosti u Hrvatskoj i dalje uvelike nadilaze prosjek EU-a.

Study aim: The aim was to estimate crude and age-standardised mortality rates for acute and recurrent myocardial infarction (MI) by Croatian counties, employing the 2013 Revised European Standard Population (RESP), for the period between 2015 and 2019. A further aim was to compare the estimated rates with average rates for Croatia and the EU, as well as to assess the association between rates and macroenomical indicators. Materials and methods: Crude and age-standardised mortality rates for acute and recurrent MI were calculated using the RESP as well as its older counterpart, the 1976 European Standard Population (ESP). Age-standardised rates were compared with average mortality rates in Croatia (for 2019) and the EU (for 2017). The EU average age-standardised mortality rate is based on RESP, and it was obtained from the Eurostat database. The number of deaths was obtained from the Croatian Institute of Public Health, whereas census data were obtained from the Croatian Central Bureau of Statistics. Moreover, we analysed the association between mortality rates and two indicators: gross domestic product (GDP) and the Index of economical strength of the Croatian Chamber of Economy (CCE). Results: Crude mortality rates for acute and recurrent MI are between 72 and 91 (per 100,000 inhabitants), with a wide inter-county range 35 to 120. Age-standardised rates based on RESP were numerically higher for most of the counties compared to rates based on ESP. In all counties the age-standardised rate exceeded the EU average rate (up to 3-fold), while rates in the inland counties were higher compared to coastal counties. While the CCE index was not significantly correlated with mortality, the GDP was negatively correlated in males (r=-0.492, p=0.023). Conclusions: Using RESP rather than ESP is a prerequisite for comparing age-standardised mortality rates with EU member states. Despite inter-county differences, age-standardised rates still largely exceed the EU average.