The regional myocardial infarction registry of Saxony-Anhalt (RHESA) in Germany – rational and study protocol

Abstract

BackgroundIn 2012 the age-standardized acute myocardial infarction (AMI) mortality rate was in the federal state Saxony-Anhalt 67 deaths per 100.000 whereas in Germany the AMI-rate was 47 deaths per 100.000. The rate in Saxony-Anhalt was therefore 43 % above the national average. Many factors may explain this above-average AMI mortality rate:First, the prevalence of cardiovascular risk factors (e.g. arterial hypertension, diabetes mellitus, smoking) in Saxony-Anhalt is the highest among all the Federal States of Germany. Second, structural health care for patients with AMI is potentially deficient (e.g. insufficient number of percutaneous coronary intervention-centers or deficits in the pre-hospital logistics of care). Third, the pre- and in-hospital process quality of health care for patients with AMI is possibly insufficient (e.g. time to reperfusion therapy).In July 2013 we established the regional myocardial infarction registry of Saxony-Anhalt (Regionales Herzinfarktregister in Sachsen-Anhalt, RHESA). RHESA is a population-based registry in the eastern part of Germany.Aims of RHESA are to calculate the AMI morbidity and mortality rates. Furthermore we study the factors that may potentially influence these rates in Saxony-Anhalt.MethodsRHESA is a population-based registry of patients with fatal or non-fatal AMI that was established in July 2013. The registry population comprises inhabitants aged 25 years or more of the city of Halle (Saale) (n = 179.000) and inhabitants of the rural district Altmark (n = 165.000) in the federal state Saxony-Anhalt, Germany.DiscussionThe main objectives of RHESA are to provide detailed estimates of the burden of AMI in Saxony-Anhalt which is the federal state with the highest AMI mortality rate in Germany and to investigate factors that influence morbidity and mortality rates due to AMI. Data collected in RHESA enable us to assess different levels of quality of health care of patients with AMI (structural, process and outcome). RHESA provides for the first time estimates of the burden of AMI in Saxony-Anhalt, and therefore contributes considerably to an improvement of the German Health Monitoring that strives for a more valid extrapolation of the nationwide morbidity and mortality rates of AMI.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-015-0040-2) contains supplementary material, which is available to authorized users.

Participation in Disease Management Programs and Major Adverse Cardiac Events in Patients After Acute Myocardial Infarction.

“…We used data from follow-up of patients registered in RHESA. RHESA and its follow-up modalities were described elsewhere [27,28]. In brief, RHESA collected information about all fatal and non-fatal myocardial infarctions in the city of Halle and in the rural region of the Altmark in Saxony-Anhalt.…”

“…In the federal state of Saxony-Anhalt, the rate of deaths related to cardiac events is 38.5% above the German average [2]. In order to investigate the causes of this increased level, a regional registry of myocardial infarction in urban and rural regions of the federal state (RHESA) was established [27].…”

The RHESA-CARE study: an extended baseline survey of the regional myocardial infarction registry of Saxony-Anhalt (RHESA) design and objectives

“…RHESA includes patients with AMI aged 25 years or more. They have to be inhabitants of the city of Halle (Saale) or of the rural district Altmark in the federal state Saxony-Anhalt, Germany [ 20 ]. RHESA-CARE comprises all patients from RHESA who have survived AMI and agree with the survey ( N = 600 per year).…”

“…To answer the question of which factors influence the mortality rate in Saxony-Anhalt, the regional myocardial infarction registry of Saxony-Anhalt (RHESA) was established in 2012. It investigated some of the factors mentioned above and is described elsewhere [ 20 ]. RHESA focuses on the comparison of an urban (city of Halle) and rural (region of Altmark) region.…”

Erfassung inzidenter kardiovaskulärer und metabolischer Erkrankungen in epidemiologischen Kohortenstudien in Deutschland

“…Zentrale Aspekte bei der Durchführung dieser Studien sind neben der Erhebung möglicher Einflussfaktoren insbesondere die Erfassung und Klassifikation neu aufgetretener (inzidenter) Erkrankungen während der Nachbeobachtungszeit. Zur Erfassung und Validierung inzidenter kardiovaskulärer Erkrankungen gibt es in Deutschland bisher nur wenige regionale Register, auf die zurückgegrif-fen werden kann [3][4][5]. Erschwerend für eine Validierung inzidenter kardiovaskulärer und metabolischer Erkrankungen kommt eine relativ starke Fragmentierung des Gesundheitssystems hinzu: An der Versorgung von kranken Menschen sind meist viele verschiedene behandelnde Personen beteiligt und es liegen nicht -wie in anderen Ländern -alle Befunde bei einem festen Hausarzt vor.…”