Outcome of Patients With Cardiac Diseases Admitted to Coronary Care Units
A Report From Lazio, Italy
Bibliographic Data
| ID | 9102920 |
|---|---|
| Authors | Carlo Saitto (Regional Health), Carla Ancona (0000-0003-0081-0655, Regional Health), Danilo Fusco (0000-0003-1759-5621, Regional Health), Massimo Arcà (Regional Health), Carlo A Perucci (Regional Health) |
| Year | 2004 |
| Volume | 42 |
| Issue | 2 |
| Pages | 147-154 |
| Publication date | 2004-02-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/01.mlr.0000109456.26657.3a |
| PMID | 14734952 |
| OpenAlex | W1975260500 |
| Language | EN |
| References cited | 16 |
BACKGROUND: Coronary care units (CCUs) currently treat a variety of diseases, but little is known about the effectiveness of CCUs on heart conditions other than acute myocardial infarction. OBJECTIVES: The objectives of this study were to evaluate the association between direct admission to CCUs and the risk of inhospital death in patients with heart disease, to investigate factors affecting direct admission to a CCU, and to assess the effect of CCU admission on the use of invasive procedures in patients with arrhythmias. RESEARCH DESIGN: We conducted a retrospective analysis of discharge-abstract data from Lazio, Italy, hospitals. We used logistic regression, propensity score, and instrumental variable analysis to compare inhospital risk of death between patients admitted to CCUs and to ordinary wards in 13 different groups of heart disease. We used linear regression to study the association between the rate of CCU admission and the relative risk of death. RESULTS: The study included 181,049 heart disease admissions, of which 8620 were admitted to CCUs (4.8%). Risk of death was significantly lower in patients admitted directly to CCUs for "acute myocardial infarction" (odds ratio [OR], 0.57), "acute ischemic heart disease" (OR, 0.55), and "other arrhythmias" (OR, 0.56). Mortality ORs were inversely related to the rate of CCU admission. CCU patients with arrhythmias received more invasive procedures (OR, 2.70) than non-CCU patients. CONCLUSION: Direct admission to a CCU is associated with a decrease in mortality for patients with "acute myocardial infarction," "acute heart ischemia," and "other arrhythmias." Patients most likely to benefit from CCU care are preferentially admitted to CCUs. CCUs make larger use of invasive procedures than ordinary wards
Cardiology · Coronary care unit · Intensive care medicine · Logistic regression · Myocardial infarction · Odds ratio · Retrospective cohort study · Acute Myocardial Infarction Research · Cardiac Arrest and Resuscitation · Emergency Medicine · Internal Medicine · Mechanical Circulatory Support Devices · Medicine
Invited Commentary
Does More Intensive Treatment of Acute Myocardial Infarction in the Elderly Reduce Mortality?
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity
Comorbidity Measures for Use with Administrative Data
Comparison of the Performance of Two Comorbidity Measures, With and Without Information From Prior Hospitalizations
| Citation velocity | historical |
|---|---|
| Highly cited | No |