Re: Comparison of hospital variation in acute myocardial infarction care and outcome between Sweden and United Kingdom: population based cohort study using nationwide clinical registries
Thank you Dr. Gupta. To investigate the influence of ethnicity on variation of AMI 30-day mortality among the UK hospitals, additional sensitivity analyses were performed.
Ethnicity information was not documented in SWEDEHAEART/RIKS-HIA. In the UK, ethnicity information was available in 214980 (55%) of the patients recorded in MINAP during the study period. 202056 (94%) were white, 1178 (0.6%) were black, and 8697 (4%) were south Asian (Indian, Pakistani, Bangladeshi, and other Asian). The averaged age and other case-mix characteristics were however similar among ethnic groups (Table).
At hospital level, higher proportion of Black patients admitted to the hospital was associated with higher hospital 30-day mortality (-0.32, p<0.001). However, the association became insignificant (-0.077, p=0.26) after adjusting for other case-mix characteristics at hospital level. Similar trend was observed between hospital admission of South Asian patients and hospital 30-day AMI mortality.
Therefore, ethnicity did not add to the existing case-mix adjustment, used in main analyses of the study. Thus, despite the different ethnicity composition, the discrepancy in hospital variation in 30-day AMI mortality remained between the two countries.
Competing interests: No competing interests