Hospitals with more patients who receive angioplasty within 90 minutes of a heart attack have lower mortality rates
Research Activities, March 2011, No. 367
Getting patients with a type of heart attack known as acute ST-segment elevation to a hospital that performs cardiac catheterization (angioplasty) to unclog blocked arteries can help prevent heart damage and death. Hospitals with the highest percentage of patients receiving angioplasty within 90 minutes of a heart attack had significantly lower overall mortality rates, found a new study.
Using information from three databases, the researchers looked at 69,101 hospital admissions coded for an acute heart attack. These admissions were from 116 hospitals who had reported more than 24 emergency admissions to their cardiac catheterization laboratories in 2006. Hospitals were divided into four quartiles depending on the percentage of patients who received angioplasty within 90 minutes of heart attack onset. The unadjusted inpatient mortality rate for the 27 hospitals in the top quartile was 4.3 percent. This compared with 5.1 percent for the 32 worst-performing hospitals in the bottom fourth quartile.
After adjusting for patient risk factors for death, there was a 17 percent lower chance of dying while in the hospital for patients admitted to top quartile hospitals when compared to the bottom quartile hospitals. The significant, lower overall mortality in these hospitals applied to both ST-segment elevation heart attacks and non-ST-segment heart attacks. In fact, the time-to-percutaneous coronary intervention (angioplasty) quality measure was a potentially important proxy measure for overall quality of care for heart attack. The study was supported in part by the Agency for Healthcare Research and Quality (HS17876).
See "The relationship between the emergent primary percutaneous coronary intervention quality measure and inpatient myocardial infarction mortality," by Rahul K. Khare, M.D., D. Mark Courtney, M.D., Raymond Kang, Ph.D., and others in the August 2010 Academic Emergency Medicine 17(8), pp. 793-800.