OBJECTIVES: To analyse trends in cardiovascular disease (CVD) mortality and hospitalisations in the Czech Republic in 1994-2009 and to assess the contribution of inhospital case-fatality rates (CFR) to changes in national CVD mortality. DESIGN: National hospitalisation and mortality registers were used to estimate rates of hospital admissions and mortality for hypertension, angina pectoris, acute myocardial infarction (AMI), chronic ischaemic heart disease chronic (IHD), heart failure and stroke. PATIENTS: All hospitalisations and deaths from CVD during 1994-2009. MAIN OUTCOME MEASURES: Average annual relative changes in age-standardised mortality, hospital admission and inhospital CFR. RESULTS: Between 1994 and 2009, 5 409 407 hospital admissions and 930 659 deaths from CVD were recorded. The age-standardised CVD mortality rate fell from 561 to 357 per 100 000 population (mean annual decline 3.1%) but hospitalisation rates remained relatively stable, with 2800 admissions per 100 000 per year (annual decline 0.7%). Inhospital CFR decreased significantly in all examined diagnoses but most rapidly for AMI (by 5.5% per year) and stroke (4.2% per year). The improvements were larger in the younger population than in elderly persons. Calculations based on unlinked mortality and hospitalisation data suggest that a decline in inhospital CFR may explain approximately 24%, 41% and 61% of the decline in national deaths from IHD, AMI and stroke, respectively. CONCLUSIONS: During the study period, the overall CVD hospitalisation rates remained high but inhospital CFR declined considerably. The improved case-fatality seems to have made a substantial contribution to the decline in the national CVD mortality, particularly for AMI and stroke.

Institute of Atmospheric Physics Academy of Sciences of the Czech Republic Prague Czech Republic

References provided by Crossref.org

Application of spatial synoptic classification in evaluating links between heat stress and cardiovascular mortality and morbidity in Prague, Czech Republic

Spatial Patterns of Heat-Related Cardiovascular Mortality in the Czech Republic

Contrasting patterns of hot spell effects on morbidity and mortality for cardiovascular diseases in the Czech Republic, 1994-2009

Impacts of hot and cold spells differ for acute and chronic ischaemic heart diseases