Hospital resources and myocardial infarction case fatality. The IBERICA study

Eva E. Álvarez-León, Roberto Elosua, Alberto Zamora, Elena Aldasoro, José Galcerá, Hermelinda Vanaclocha, Antonio Segura, Miquel Fiol, Javier Turumbay, Gloria Pérez, José M. Arteagoitia, María J. Tormo, Adolfo Cabadés, Gema Vega, José Ignacio Ayestarán, Vega García, Iraida Hurtado-de-Saracho, Carmen Navarro, Oscar Zurriaga, Javier MuñizJoan Sala, Jaume Marrugat, Eva Alonso, Fernando Arós, Covadonga Audicana, Mikel Basterretxea, Eduardo Castillo, Santiago Esnaola, Miguel A. García Calabuig, Iraida Hurtado-de-Saracho, Miren Josebe Laresgoiti, Nerea Larrañaga, María José Lasa, Nerea Muniozguren, M. Cres Tobalina, Jesús M. San Vicente, Emilio Sanz, Lluís Cirera, José García, Carmen Navarro, José Tormo, Consuelo Martínez, Josefa Contreras, Fuesanta Aliaga, José M. Alonso, Manuel Belda, Rafael Bañón, José A. Castaño, Antonio Castilla, Juan Manuel Chiner, José M. Clemente, Amparo Egea, Francisco Felices, Manuel Fuentes, José Galcerá, Arcadio García, Pedro García, Gurmesindo González, Faustino Herrero, Pedro Jara, José Antonio Melgarejo, José Muñoz, Silvestre Nicolás, Juan Ortega, Miguel de Paco, Emilio Pérez, Pascual Rodríguez, Francisco Javier Rodríguez, Julio Ródenas, Francisco Ruiz-Martínez, José Antonio Ruiz, Fernando de San Eustaquio, Josefa Segura, José Antonio Serrano, Gines Torres, Luis Carlos Torres, Juan Vidal, Manuel Villegas, Amparo Albiñana, Carlos Antón, Joaquín Arguedas, Santiago Borrás, Susana Bosch

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Abstract

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 (0R=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.
Original languageEnglish
Pages (from-to)514-523
JournalRevista Espanola de Cardiologia
Volume57
Issue number6
DOIs
Publication statusPublished - 1 Jan 2004

Keywords

  • Epidemiology
  • Fatality
  • Mortality
  • Myocardial infarction

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    Álvarez-León, E. E., Elosua, R., Zamora, A., Aldasoro, E., Galcerá, J., Vanaclocha, H., Segura, A., Fiol, M., Turumbay, J., Pérez, G., Arteagoitia, J. M., Tormo, M. J., Cabadés, A., Vega, G., Ayestarán, J. I., García, V., Hurtado-de-Saracho, I., Navarro, C., Zurriaga, O., ... Bosch, S. (2004). Hospital resources and myocardial infarction case fatality. The IBERICA study. Revista Espanola de Cardiologia, 57(6), 514-523. https://doi.org/10.1157/13062917