Calculating the 30-day survival rate in acute myocardial infarction: should we use the treatment chain or the hospital catchment model?
Abstract
Overview
Introduction.
Acute myocardial infarction (AMI) is a potentially deadly disease and significant efforts have been
concentrated on improving hospital performance. A 30-day survival rate has become a key quality of care indicator. In Northern Norway, some patients undergoing AMI are directly transferred to the Regional Cardiac Intervention Center at the University Hospital of North Norway in Tromsø. Here, coronary angiography and percutaneous
coronary intervention is performed. Consequently, local hospitals may be bypassed in the treatment chain, generating differences in case mix, and making the treatment chain model difficult to interpret. We aimed to compare
the treatment chain model with an alternative based on patients’ place of living.
Methods.
Between 2013 and 2015, a total of 3,155 patients were registered in the Norwegian Patient Registry
database. All patients were categorized according to their local hospital’s catchment area. The method of Guo-Romano, with an indifference interval of 0.02, was used to test whether a hospital was an outlier or not. We
adjusted for age, sex, comorbidity, and number of prior hospitalizations.
Conclusions.
We revealed the 30-day AMI survival figure ranging between 88.0% and 93.5% (absolute difference
5.5%) using the hospital catchment method. The treatment chain rate ranged between 86.0% and 94.0% (absolute difference 8.0%). The latter figure is the one published as the National Quality of Care Measure in Norway.
Local hospitals may get negative attention even though their catchment area is well served. We recommend the
hospital catchment method as the first choice when measuring equality of care.
Keywords
Myocardial infarction, Norway, Quality, Survival
Article Information
Disclosure
Financial support: The publication charges for this article have been funded by a grant from the publication fund of UiT – The Arctic University of Norway.
Correspondence
Jan Norum Department of Clinical Medicine Faculty of Health Science UiT – The Arctic University of Norway HansineHansens veg 74 N-9019 Tromsø, Norway jan.norum@uit.no
Further Resources
Trending Topic
Cardiovascular diseases are the most common cause of mortality and morbidity in adults worldwide.1Â Coronary angiography (CAG) is the gold standard method for evaluating atherosclerotic coronary artery disease (CAD).2Â It is conventionally performed via the trans-femoral (TF) route. Recently, however, the trans-radial (TR) route has become the preferred way.3Â The TR route offers better procedure comfort, shorter hospitalization […]
We are sorry to announce the death of one of our valued editorial board members, Dr Richard Heuser (November 17, 1950–May 23, 2024). Richard R Heuser, MD, FACC, FACP, FESC, MSCAI, was an internationally recognized cardiologist, inventor, educator and author, and was a ...
Welcome to the summer issue of Heart International. We are excited to present a collection of insightful articles that delve into various aspects of cardiovascular health and related interventions. This issue encompasses a wide array of topics, from novel treatment ...
Clinically relevant tricuspid regurgitation (TR) is a common disorder, affecting approximately 4% of people 75 years of age or older.1Â If left untreated, severe TR results in volume overload and right ventricular remodelling. This eventually leads to symptomatic right-sided heart failure, along ...
In this issue of Heart International, we are delighted to present a collection of insightful articles that encompass a wide spectrum of topics within the field of cardiovascular medicine. As we navigate the landscape of cardiovascular disease, heart failure, preventative ...
For decades, right ventricular pacing (RVP) has been the leading pacing technique and has been proven to be effective in treating patients with symptomatic bradycardia. However, dyssynchrony caused by non-physiological ventricular activation results in pacing-induced cardiomyopathy occurs in approximately 15% of ...
Welcome to the latest issue of Heart International. This edition includes a range of articles on topics showcasing the latest advances in our understanding and treatment of cardiovascular disease. We begin with focus on the hereditary cardiac disorder, hypertrophic cardiomyopathy, ...
A significant proportion of patients with atrial fibrillation (AF) who have a high stroke risk are currently being treated with oral anticoagulation (OAC), including direct oral anticoagulants (DOACs) and vitamin K inhibitors (VKAs).1Â It is well known that the increased ...
The American Diabetes Association (ADA) defines prediabetes as glycated haemoglobin (HbA1c) 5.7–6.4% or fasting plasma glucose (FPG) 100–125 mg/dL or 5.6–6.9 mmol/L.1 Patients with prediabetes have up to a 70% chance of developing diabetes and a two-fold higher risk of cardiovascular ...
Mitral valve (MV) disease includes either mitral regurgitation or mitral stenosis or both. The incidence and prevalence of valvular heart disease is increasing with the increasing population age. Degenerative MV disease poses a global burden with a prevalence of 18.1 million ...
Welcome to the latest issue of Heart International. Cardiovascular science continues to evolve at an impressive rate, and the range of articles presented here highlights cutting-edge technology and innovation within cardiology. We begin with a commentary by Divaka Perera on ...
Welcome to the latest issue of Heart International. We are delighted to bring you another excellent issue, full of the varied and expert articles that you can expect from our authors. We begin with some exciting news. We are delighted ...
Tricuspid regurgitation (TR) is a complex disease with several independent causes. Consequently, outcomes and response to therapy vary widely. Severe or progressive TR often results in gradual right ventricular (RV) failure and is associated with poor long-term outcomes.1Â Most cases ...
Log into your Touch Account
Earn and track your CME credits on the go, save articles for later, and follow the latest congress coverage.
Sign up with an Email
Or use a .
This Functionality is for
Members Only
Explore the latest in medical education and stay current in your field. Create a free account to track your learning.
