Pealkiri: 

Better outcomes for acute myocardial infarction patients first admitted to PCI hospitals in Estonia

Autorid: Blöndal M , Ainla T , Marandi T , Baburin A , Rahu M , Eha J
Väljaandja/tellija: Acta Cardiologica
Märksõnad: südame-veresoonkonna haigused, tervishoiukorraldus, tervishoid, tervishoiutöötajad, haiglad
Välja antud: 2010
Tüüp: Teaduslik artikkel/kogumik
Viide: Blöndal M, Ainla T, Marandi T, et al. Better outcomes for acute myocardial infarction patients first admitted to PCI hospitals in Estonia. Acta Cardiologica 2010;65(5):541-548.
Link: http://www.ncbi.nlm.nih.gov/pubmed/21125976
Alamvaldkonnad:Terviseteenuste korraldus, kättesaadavus ja kvaliteet
Mittenakkushaigused
Kirjeldus: OBJECTIVE:
The objective of this study was to compare process of care, in-hospital outcomes, and 1-year mortality of patients with acute myocardial infarction (AMI) first admitted to hospitals with and without percutaneous coronary intervention (PCI) facilities in Estonia in 2007.
METHODS:
We conducted a retrospective cross-sectional study on a random sample of hospitalized AMI patients. Data on process of care and in-hospital outcomes were abstracted from patient records in 16 hospitals according to a standardized study form.
RESULTS:
Patients first admitted to PCI hospitals (n = 327) had higher rates of overall use of coronary angiography (78.3% vs. 24.7%; P < 0.001), revascularization (64.2% vs. 20.6%; P < 0.001), and echocardiography (85.3% vs. 65.3%, P < 0.001) than those first admitted to non-PCI hospitals (n = 360). Among the non-PCI hospital patients those selected for cardiac catheterization were younger, healthier, and had better clinical status on presentation. Patients admitted to PCI hospitals had higher prescription rates of in-hospital and discharge evidence-based medications except for beta-blockers. PCI hospitals' patients had lower in-hospital mortality (11.3% vs. 19.2%, P = 0.004) and 1-year mortality (24.5% vs. 34.7%, P = 0.003), results remained significant after adjustment for baseline characteristics (odds ratio 0.47; 95% confidence interval 0.28-0.78, hazard ratio 0.66; 95% confidence interval 0.48-0.90).
CONCLUSIONS:
There are disparities in process of care, in-hospital and 1-year mortality between patients first admitted to PCI vs. non-PCI hospitals in Estonia. Patients admitted to non-PCI hospitals should undergo more vigorous risk stratification using invasive and non-invasive methods; use of evidence-based medicine should be encouraged even if cardiac revascularization is not done.