| Objective To analyze the clinical characteristics, mode of death and death time of the hospitalized death cases, to describe changes in the in-hospital case-fatality rates associated with acute myocardial infarction (AMI) or chronic heart failure (CHF), and to provide more information on the prevention and treatment strategy of AMI and CHF.Methods A retrospective cohort study was used. From January of 1985 to December of 2003, a total of 654 hospitalized death cases in cardiology department, there included 608 death cases in AMI or CHF. The retrospective analysis and comparison were performed respectively.Results 1. Hospitalized death cases with AMI: (1) There were 308 deathcases with AMI during 19 years. The proportion of males was 53.6%, no significant sex constitution difference during period 1st to 4th(P>0.05). The average age were from (65.64+7.76) to (72.50+9.25) years during period 1st to 4th , the age was aged, the proportion of ^75 years increased from 15.6% to 41.4%, the age between sex was no significant difference (P>0.05). The symptom-onset-to-door time and symptom-onset-to-death time were no significant difference during period 1st to 4th and between sex. (2) In terms of past history, no major difference were found during period 1st to 4th with the exception of a significantly increased prevalence of diabetes mellitus (17.2%, 23.3%, 37.1%, 38.6%, respectively), the proportion of women with a history of hypertension were significantly higher than that of man (P<0.001). Within all of death cases, the proportion of Killip class I were the highest at admission , then were Killip class III at death. (3) There were marked changes in treatment routines, the use of thrombolytic agents increased during period 1st to 3rd, then decreased during period 4th (4.7%, 38.4%, 44.6% and 32.9% respectively), the increased use of PTCA took place during 3rd to 4th (1.0% and 11.4%). In terms of pharmacological treatment, the use of ACEI, B -blocker, ASA, anticoagulants, statin and sodium nitroprusside increased significantly step by step (P<0.01), calcium-channel blockers decreased significantly (P<0.001). (4) The three main mode of death were in turn sudden cardiac death (35.4%), pump failure (26.9%) and cardiogenic shock (25.3%). The distribution of the same mode of death was no significant difference over time, the same as between sex. (5) The total in-hospital case-fatality rate was 11.8%. During period 1st to period 4th, the in-hospital case-fatality rates were 18.0%, 15.6%, 11.6% and 7.5%, respectively, there was a marked declining trends over time. The male s mortality rates were lower than the female's of the same period (13.6%vs28.8%, 13.4%vs20.1%, 9.4%vsl6.4%, 5.8%vsll.3%, respectively). (6) The death months were significantly cumulative in December.2. Hospitalized death cases with CHF: (1) There were 300 death cases with CHF during 19 years. The proportion of males was 53.7%, no significant sex constitution difference during period 1st to 2nd (P>0.05). The median age were from 62 years (25th percentile 46,75th percentile 72 years) to 70 years (25th percentile 61, 75th percentile 75 years) during period 1st to 2nd, the age was aged, the proportion of >65 years increased from 42.8% to 65.5%. The age of males were significantly older than that of females (PO.01), were 68(57 75) years and 63(52 72) years respectively. Survival time after diagnosed HF was 5(2 10) years. (2) The two major causes of HF were Coronary Heart Disease (CHD) and Rheumatic Heart Disease (RHD), with 52.0% and 28.3% respectively. The proportion of RHD decreased significantly (36.2%vs 20.3%, PO.01) and CHD increased significantly (43.4%vs60.8%, PO.01). The distribution of causes was characteristic of sex and age, the females were prone to RHD and the males were CHD; the majority over 75 years was CHD (86.5%). (3) The proportion of cases with a history of hypertension, diabetes mellitus, OMI and angina pectoris increased significantly over time (P<0.05). Cases accompanied with arrhythmia, pneumonia, hyponatremia, renal insuffic...
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