TUESDAY, Nov. 3, 2026 (HealthDay News) -- Rural residence is the strongest independent predictor of prehospital death among acute myocardial infarction (AMI) decedents, according to a study presented at the American Heart Association Scientific Sessions 2026, held from Nov. 6 to 9 in Chicago.
Darshan Shivanne Gowda, M.B.B.S, from the Hassan Institute of Medical Sciences in Mysuru, India, and colleagues examined sociodemographic predictors of place of death (POD) among 2,532,610 adults aged 20 years or older with AMI from 2003 to 2023.
The researchers found that rural residence was the strongest predictor of prehospital death, with nearly threefold higher odds of dead on arrival (DOA) and elevated odds of home and outpatient death for rural residents versus large metropolitan residents (adjusted odds ratios, 2.91, 1.89, and 1.58, respectively). Compared with White decedents, Black decedents had higher odds of outpatient death and DOA (adjusted odds ratios, 1.25 and 1.16, respectively). The highest relative odds of DOA and emergency room death were seen for younger adults (aged 20 to 44 years), with progressive decreases with age. Independent associations were seen for male versus female sex with higher DOA and outpatient death (adjusted odds ratios, 1.39 and 1.25, respectively). Consistently lower odds of out-of-hospital death were seen for Hispanic versus non-Hispanic decedents. The likelihood of dying in a nursing home/long-term care facility and hospice was higher for adults aged 65 years and older (adjusted odds ratios, 6.38 and 2.14, respectively).
"We found that people who live in rural areas and certain other populations were more likely to die before receiving urgent care for a heart attack that would improve their chances of survival," Gowda said in a statement.
