Issued in 2015 – RIKS-HIA

RIKS-HIA Annual report 2014

Issued in 2015 – RIKS-HIA Working group RIKS-HIA 2014 Chair Tomas Jernberg, MD, PhD, Stockholm Olle Bergström, MD, Växjö Lena Forsman, MD, Enköping Claes Held, MD, PhD, Uppsala Karin Hellström-Ängerud, RN, Umeå Thomas Kellerth, MD, Örebro Johan Lugnegård, MD, Uppsala Ewa Mattson, RN, Lund Annica Ravn-Fischer, MD, PhD, Gothenburg Erik Rydberg, MD, PhD, Lund Anette Sandström, MD, Lycksele

Issued in 2015 – RIKS-HIA Figure 1. Coverage of MI patients < 80 years registered in RIKS-HIA compared to the patient registry, per discharging hospital, 2013.

Issued in 2015 – RIKS-HIA Figure 2. Coverage of MI patients ≥ 80 years registered in RIKS-HIA compared with the patient registry, per discharging hospital, 2013.

Issued in 2015 – RIKS-HIA Figure 3. Relative distribution of age groups by hospital in AMI patients, all ages, per hospital with ≥ 10 patients, 2014.

Issued in 2015 – RIKS-HIA Figure 4. Distribution of AMI patient numbers and ages per hospital, all ages, 2014.

Issued in 2015 – RIKS-HIA Figure 5. Proportion of MI categories according to ECG at admission, all ages, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 6. Proportion of STEMI patients, arriving at hospital by ambulance who were not referred from other hospitals, per county council, 2010–2014.

Issued in 2015 – RIKS-HIA Figure 7. Proportion of NSTEMI patients, arriving at hospital by ambulance who were not referred from other hospitals, per county council, 2010–2014.

Issued in 2015 – RIKS-HIA Figure 8. Distribution of MI type among MI patients < 80 years, per discharging hospital with ≥ 10 patients, 2014.

Issued in 2015 – RIKS-HIA Figure 9. Trend in mean age in AMI patients, all ages, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 10. Trend in incidence of background factors in MI patients < 80 years, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 11. Trend in emergency reperfusion treatment in STEMI patients < 80 years, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 12. Proportion of bleeding complications following MI, all ages, per year, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 13. Proportion of bleeding complications following thrombolysis, all ages, per year, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 14. Proportion of reperfusion treatment in STEMI patients < 80 years, per county council, 2014.

Issued in 2015 – RIKS-HIA Figure 15. Proportion of reperfusion treatment in STEMI patients < 80 years, per hospital (the hospital’s mean value is used in the RIKS-HIA quality index), 2014 RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 16. Trend in reperfusion treatment in STEMI patients in relation to age and gender, all ages, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 17. Distribution of reperfusion treatments in STEMI patients < 80 years, per county, 2014.

Issued in 2015 – RIKS-HIA Figure 18. Trend in median delay time for primary PCI or thrombolysis in MI patients, all ages, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 19. Delay time (median, 25th and 75th percentiles) from onset of symptoms to primary PCI in MI patients, all ages, per hospital with ≥ 20 times ≤ 12 hours, 2014.

Issued in 2015 – RIKS-HIA Figure 20. Start of reperfusion treatment within recommended time (90 min for PCI, 30 min for thrombolysis) from ECG in STEMI patients < 80 years, per hospital (the hospital’s county council’s mean value is used in the RIKS-HIA quality index), 2014 RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 21. Start of reperfusion treatment within recommended time (90 min for PCI, 30 min for thrombolysis) from ECG in STEMI patients < 80 years, per county council (the hospital’s county council’s mean value is used in the RIKS-HIA quality index), 2014 RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 22. Start of reperfusion treatment within 120 min for PCI or 30 min for thrombolysis from ECG in STEMI patients < 80 years, per hospital (the hospital’s county council’s mean value is used in the RIKS-HIA quality index), 2014 RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 23. Start of reperfusion treatment within 120 min for PCI or 30 min for thrombolysis from ECG in STEMI patients < 80 years, per county council (the hospital’s county council’s mean value is used in the RIKS-HIA quality index), 2014 RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 24. Proportion of NSTEMI patients < 80 years receiving parenteral fondaparinux, LMWH or PCI within 24 hours, per hospital with ≥ 10 patients, 2014.

Issued in 2015 – RIKS-HIA Figure 25. Proportion of use of parenteral beta-blockers in MI patients, per hospital with ≥ 10 patients, all ages, 2014.

Issued in 2015 – RIKS-HIA Figure 26. Proportion of use of parenteral nitroglycerin in MI patients, per hospital with ≥ 10 patients, all ages, 2014.

Issued in 2015 – RIKS-HIA Figure 27. Trend in coronary angiography in NSTEMI patients in relation to age and gender, discharged alive, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 28. Proportion of coronary angiography in NSTEMI patients < 80 years, discharged alive, per hospital with ≥ 10 patients, 2014.

Issued in 2015 – RIKS-HIA Figure 29. Proportion of NSTEMI patients < 80 years undergoing angiography and time to examination, per hospital with ≥ 10 patients, RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 30. Proportion of NSTEMI patients < 80 years undergoing angiography (only examinations within 3 days) and time to examination, per hospital with ≥ 10 patients, 2014.

Issued in 2015 – RIKS-HIA Figure 31. Proportion of NSTEMI patients 140, per hospital with ≥ 10 patients, 2014.

Issued in 2015 – RIKS-HIA Figure 32. Trend in coronary angiography in STEMI patients in relation to age and gender, discharged alive, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 33. Trend in PCI/CABG in AMI patients during hospital admission in relation to age and gender, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 34. Proportion of MI patients undergoing echocardiography, all ages, per hospital with ≥ 10 patients, 2014.

Issued in 2015 – RIKS-HIA Figure 35. Proportion of MI patients < 80 years receiving beta-blockers at discharge per discharging hospital with ≥ 10 patients, RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 36. Proportion of MI patients < 80 years with heart failure or left ventricular dysfunction receiving beta- blockers at discharge per discharging hospital with ≥ 10 patients, 2014.

Issued in 2015 – RIKS-HIA Figure 37. Proportion of MI patients < 80 years receiving lipid-lowering drugs at discharge per discharging hospital with ≥ 10 patients, RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 38. Trend in use of lipid-lowering drugs (statin or other) at discharge in MI patients in relation to age and gender, all ages, discharged alive, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 39. Proportion of MI patients < 80 years receiving ACEI/ARB at discharge per discharging hospital with ≥ 10 patients, RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 40. Proportion of MI patients < 80 years receiving aspirin etc. at discharge per discharging hospital with ≥ 10 patients, RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 41. Trend in use of antithrombotic treatment at discharge in MI patients, all ages, discharged alive, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 42. Proportion of MI patients < 80 years receiving P2Y12 receptor blockers at discharge per discharging hospital with ≥ 10 patients, RIKS-HIA quality index (0.5/1 points) see Table 1.

Issued in 2015 – RIKS-HIA Figure 43. Proportion of use of P2Y12 receptor blockers at discharge in NSTEMI patients < 80 years, per month, 2011–2014.

Issued in 2015 – RIKS-HIA Figure 44. Proportion of use of P2Y12 receptor blockers at discharge in STEMI patients < 80 years, per month, 2011–2014.

Issued in 2015 – RIKS-HIA Figure 45. Proportion of STEMI patients < 80 years receiving P2Y12 receptor blockers at discharge, per county for discharging hospital, 2014.

Issued in 2015 – RIKS-HIA Figure 46. Proportion of NSTEMI patients < 80 years receiving P2Y12 receptor blockers at discharge, per county for discharging hospital, 2014.

Issued in 2015 – RIKS-HIA Figure 47. Proportion of NSTEMI patients ≥ 80 years receiving P2Y12 receptor blockers at discharge, per county for discharging hospital, 2014.

Issued in 2015 – RIKS-HIA Figure 48. Proportion of NSTEMI patients < 80 years receiving P2Y12 receptor blockers in combination with warfarin at discharge, per county for discharging hospital, 2014.

Issued in 2015 – RIKS-HIA Figure 49. Planned duration of P2Y12 receptor blocker treatment in MI patients without concomitant anticoagulant (AC) treatment, 2014.

Issued in 2015 – RIKS-HIA Figure 50. Planned duration of P2Y12 receptor blocker treatment in MI patients without concomitant AC treatment who have undergone PCI, 2014.

Issued in 2015 – RIKS-HIA Figure 51. Planned duration of P2Y12 receptor blocker treatment in MI patients without concomitant AC treatment who have not undergone PCI, 2014.

Issued in 2015 – RIKS-HIA Figure 52. Trend in use of AC treatment at discharge in MI patients with atrial fibrillation (AF), all ages, discharged alive, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 53. Proportion of AC treatment in MI patients with AF, all ages, discharged alive, 1995–2014.

Issued in 2015 – RIKS-HIA Figure 54. Proportion of MI patients with AF recieving antithrombotic treatment and/or AC at discharge, all ages discharged alive, per hospital with ≥ 10 patients in the target group, 2014.

Issued in 2015 – RIKS-HIA Figure 55. Number of MI patients < 80 years with NOAC treatment (dabigatran, rivaroxaban, or apixaban) at admission, per county council, 2014.

Issued in 2015 – RIKS-HIA Figure 56. Distribution of length of stay for STEMI patients < 80 years, per hospital with ≥ 10 patients, 2014.

Issued in 2015 – RIKS-HIA Figure 57. Distribution of length of stay for NSTEMI patients < 80 years, per hospital with ≥ 10 patients, 2014.

Issued in 2015 – RIKS-HIA Figure 58. Mortality rate in different types of MI patients, all ages, 2012–2013.

Issued in 2015 – RIKS-HIA Figure 59. Mortality rate in MI patients, in relation to renal dysfunction (GFR ≤ 60 mL/min) and DM, all ages, 2012–2013.

Issued in 2015 – RIKS-HIA Figure day mortality in MI patients, in relation to age and gender, all patients, 2013–2014.

Issued in 2015 – RIKS-HIA Figure 61. One-year mortality in MI patients, in relation to age and gender, all patients, 2012–2013.

Issued in 2015 – RIKS-HIA Figure 62. Trend in mortality for MI patients 70–79 years, 1995–2014.

Issued in 2015 – RIKS-HIA Figure day mortality for MI patients < 80 years in the patient’s home county, 2013–2014.

Issued in 2015 – RIKS-HIA Figure 64. One-year mortality for MI patients < 80 years in the patient’s home county, 2012–2013.

Issued in 2015 – RIKS-HIA Figure day mortality for MI patients < 80 years per hospital with ≥ 20 patients, 2013–2014 (mean, 95 % CI).

Issued in 2015 – RIKS-HIA Figure 66. One-year mortality for MI patients < 80 years per hospital with ≥ 20 patients, 2012–2013 (mean, 95 % CI).

Issued in 2015 – RIKS-HIA Figure 67. The upper part of figure shows the observed one-year mortality for each unit, indicated as an unfilled circle (the more patients the larger the circle), together with the predicted mortality as a filled circle. Green circles indicate that mortality is lower than predicted, while red circles indicate that the mortality is higher than predicted. The lower part of the figure shows the difference in observed and predicted mortality together with the 95 % CI.

Issued in 2015 – RIKS-HIA Figure 68. The funnel plot to the left shows mortality in each unit without taking case mix into account. The funnel plot to the right indicates the difference between observed mortality and predicted mortality according to the patient’s background factors.

Issued in 2015 – RIKS-HIA Figure 69. RIKS-HIA quality index, patients < 80 years, per hospital with ≥ 10 patients in the target group, 2014.

Issued in 2015 – RIKS-HIA Table 1. The RIKS-HIA quality index. Target group sample relates to type 1 MI in patients < 80 years. For more detailed information of the criteria for RIKS-HIA quality index, find the full chart at