Heart attack patients often react too late

Heart attack patients often respond too late: Large West-East divide in the mortality rate of heart attack patients

04/01/2011

The chances of surviving a heart attack have improved significantly in Germany over the past 20 years. While eleven out of every 10,000 people died of circulatory disturbances in the heart muscle in 1990, today there are only seven.

Regional differences in survival after a heart attack
Every second counts after suffering a heart attack. Who in the „golden first hour“ after the onset of medical treatment, have high chances of survival med. Karl-Friedrich Appel, cardiologist in the Outpatient Heart Center Kassel.Ob surviving the patients is according to the results of the latest heart report, but not least a question of residence. Because medical care is very different in Germany. According to the author, some regions are interested in cardiology and cardiac surgery in Germany for the cross-sectoral care analysis. Ernst Bruckenberger, „in the nationwide comparison (...) less well there“. It should be noted in Germany in general, a steep west-east divide, the Ministerialrat a.D. at the Lower Saxony Ministry of Social Affairs and author of the Heart Report 2009, Dr. med. Bruckenberger continues. To the east of the circular borders of the Werra-Meißner-Kreis start a kind „cardiac surgical desert“, with significantly higher mortality rates in a heart attack. „The range of the heart attack death rate between the individual counties is considerable“, explained Dr. Bruckenberger. For example, in Eisenach the mortality rate is more than twice as high as in the Werra-Meißner district. But even patients who suffer a heart attack in Waldhessen, according to the current heart report, according to poorer survival than heart attack patients in the neighboring districts.

Bad performance despite good medical infrastructure
In addition, the heart report lists some regions with particularly high mortality rates, which actually have a good medical infrastructure for the treatment of heart attack patients. Herzfeld-Rothenburg is one of these examples. 109 district residents died here in 2008 of an acute heart attack, which corresponds to an almost eight percent increase in the mortality rate compared to the national average. Despite the cardiovascular center (HKZ) in Rotenburg and the cardiology department at Bad Hersfeld Hospital, the region is doing relatively poorly. According to Bruckenberger, it is crucial for the patients' chances of survival whether and how fast a patient is placed with a suspected heart attack a catheter. For this purpose are in principle „enough measuring stations (...) in a circle“, like Dr. Christian Vallbracht, Director of Cardiology at the HKZ, confirmed that many of the patients lost a lot of time because the nearest possible cardiac catheterization site would be activated, even if immediate catheter treatment was not possible at this time. In general, the untreated heart attack patients are the biggest problem, as the heart report clearly states. „The hesitation of the patient gives too many minutes away“, explained Dr. Christian Vallbracht.

Reduction of mortality rates through expansion of medical technology
The significant reduction in the Germany-wide mortality rate for heart attacks is essentially due to the expansion of medical technology. For example, over the past 20 years clinics have been upgraded to cardiac surgery centers across Germany to improve patient care. For example, the number of catheter measuring stations and the number of catheter examinations performed with it were quadrupled throughout Germany. But the success is significantly clouded by the above-average mortality rates in each region. Therefore, should „Exceedances of federal value (...) Reason for health policy measures“ in the affected regions, emphasized Bruckenberger. The author of the Heart Report demands to check the speed, quality and organization of the ambulance service as well as the distance to the nearest cardiological department with catheter measuring station and if necessary to improve it. Thus, the clear West-East divide was primarily due to the poorer medical care in the new federal states, which could be identified and remedied as part of the review he called for, "Dr. Bruckenberger. From one „even in approximately even supply landscape“ For the essential heart diseases could not be spoken so far, although the treatment options in Germany are generally relatively good, stressed the author of the Heart Report. (Fp)

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