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Coronary heart disease and related procedures. National Hospital Discharge Survey data.

The National Hospital Discharge Survey provides cross-sectional and trend data for analysis of cardiovascular diseases that may require surgery or other procedures. Overall, there was a decline in the hospital discharge rate for all causes since 1983. However, the number of discharges with first-listed coronary artery-related diagnoses increased between 1984 and 1986. For men, the estimated number of these discharges increased from 1,161,000 to 1,323,000. For both sexes, there was a decrease for chronic ischemic heart disease; however, the number of discharges for unstable angina pectoris doubled over this period. It is uncertain whether this reflects an increase in disease or is the result of reimbursement policies affecting diagnosis. For both unstable and stable angina pectoris, there was a reversal of the male-female ratio at older ages, with larger numbers of older women than men discharged with these diagnoses. The discharge rates for all-listed acute myocardial infarction remained relatively constant over the past 7 years. However, the average length of stay decreased. Dysrhythmias and heart failure were the most frequent complications listed. The number of coronary artery bypass graft surgery discharges increased from 114,000 in 1979 to 228,000 in 1986. The increase in coronary angioplasty is noteworthy, rising from 2,000 to 133,000 in the same period. For both procedures, the most frequently associated diagnosis was chronic ischemic heart disease. Further monitoring of hospital discharge trends for coronary heart disease and related procedures is indicated.