Hospital resources and myocardial infarction case fatality.: The IBERICA study

被引:19
作者
Alvarez-León, EE
Elosua, R
Zamora, A
Aldasoro, E
Galcerá, J
Vanaclocha, H
Segura, A
Fiol, M
Turumbay, J
Pérez, G
Arteagoitia, JM
Tormo, MJ
Cabadés, A
Vega, G
Ayestarán, JI
García, V
Hurtado-de-Saracho, I
Navarro, C
Zurriaga, O
Muñiz, J
Sala, J
Marrugat, J
Aldasoro, E
Alonso, E
Arós, F
Arteagoitia, JM
Audicana, C
Basterretxea, M
Castillo, E
Esnaola, S
Calabuig, MAG
Laresgoiti, MJ
Larrañaga, N
Lasa, MJ
Lecuona, F
Muniozguren, N
Tobalina, MC
Vicente, JMS
Sanz, E
Cirera, L
García, J
Navarro, C
Tormo, MJ
Martinez, C
Contreras, J
Aliaga, F
Alonso, JM
Belda, M
Bañón, R
Castaño, JA
机构
[1] IMIM, Unitat Lipids & Epidemiol Cardiovasc, Barcelona 08003, Spain
[2] Gobierno Vasco, Dept Sanidad, Vitoria, Spain
[3] Hosp Virgen Arrixaca, Unidad Cuidados Intens, Murcia, Spain
[4] Conselleria Sanitat & Consum General Valenciana, Valencia, Spain
[5] Consejeria Sanidad Castilla La Mancha, Inst Ciencias Salud, Talavera Reina, Toledo, Spain
[6] IUNCS, Palma de Mallorca, Spain
[7] Inst Salud Publ Navarra, Pamplona, Spain
[8] Dept Sanitat & Seguretat Social, Serv Informacio & Estudis, Barcelona, Spain
[9] Consejeria Sanidad & Consumo, Dept Epidemiol, Murcia, Spain
[10] Hosp La Fe, Unidad Cuidados Intens, E-46009 Valencia, Spain
[11] Complejo Hosp Albacete, Unidad Cuidados Intens, Albacete, Spain
[12] Asociac Estudios Biomed Galicia, La Coruna, Spain
[13] Univ A Coruna, Inst Univ Ciencias Salud, La Coruna, Spain
[14] Hosp Josep Trueta, Unitat Coronaria, Girona, Spain
[15] Univ Autonoma Barcelona, E-08193 Barcelona, Spain
来源
REVISTA ESPANOLA DE CARDIOLOGIA | 2004年 / 57卷 / 06期
关键词
D O I
10.1016/S1885-5857(06)60627-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction and objectives. To determine the proportion of patients with myocardial infarction (MI) not admitted to a coronary care unit (CCU), the variables associated with admission into a CCU, and whether admission to a CCU, and the availability of coronary angiography in the same hospital, were associated with 28-day case fatality. Patients and method. Population-based registry of MI in patients 25 to 74 years of age, admitted during 1996-1998. Demographic and clinical characteristics were recorded, as well as management, clinical course and survival after 28 days. Hospitals were classified according to the availability of a CCU and catheterization laboratory (advanced hospital), CCU only (intermediate hospital) or neither (basic hospital). Admission to the CCU was also recorded. Results. In all, 9046 cases of MI were recorded; in 11.3% the patient was not admitted to a CCU. Age, smoking (OR = 1.33; 95% CI, 1.08-1.64), non-Q MI (OR = 0.62; 95% CI, 0.49-0.78) or undetermined location of MI (OR = 0.34; 95% CI, 0.23-0.50), Killip 4 score on admission (OR = 0.63; 95% CI, 0.40-1.00) and delay in arrival at the hospital >6 h were associated with CCU admission. Patients admitted to a CCU showed a lower case fatality in the first 24 h (4.2% vs 23.5%), which was independent of comorbidity, severity and treatment. The 24-hour survivors admitted to a basic hospital had higher case fatality (17.3% vs 7.8%) than other groups, which was related to differences in treatment. Conclusions. CCU admission is associated with a lower case fatality in the first 24 h. Admission to a basic hospital is associated with a higher 28-day case fatality even in patients who survive 24 h.
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收藏
页码:514 / 523
页数:10
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