دورية أكاديمية
The volume of primary angioplasty procedures and survival after acute myocardial infarction. National Registry of Myocardial Infarction 2 Investigators
| العنوان: | The volume of primary angioplasty procedures and survival after acute myocardial infarction. National Registry of Myocardial Infarction 2 Investigators |
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| المؤلفون: | Canto, John G., Every, Nathan R., Magid, David J., Rogers, William J., Malmgren, Judith A., Frederick, Paul D., French, William J., Tiefenbrunn, Alan J., Misra, Vijay K., Kiefe, Catarina I., Barron, Hal V. |
| المساهمون: | Department of Quantitative Health Sciences |
| المصدر: | The New England journal of medicine ; 342 ; 21 ; 1573-80 |
| سنة النشر: | 2022 |
| المجموعة: | University of Massachusetts, Medical School: eScholarship@UMMS |
| مصطلحات موضوعية: | Angioplasty, Transluminal, Percutaneous Coronary, numerical data, Hospital Mortality, Humans, Logistic Models, Myocardial Infarction, Registries, Risk, Thrombolytic Therapy, Time Factors, United States, Bioinformatics, Biostatistics, Epidemiology, Health Services Research |
| الوصف: | BACKGROUND: There is an inverse relation between mortality from cardiovascular causes and the number of elective cardiac procedures (coronary angioplasty, stenting, or coronary bypass surgery) performed by individual practitioners or hospitals. However, it is not known whether patients with acute myocardial infarction fare better at centers where more patients undergo primary angioplasty or thrombolytic therapy than at centers with lower volumes. METHODS: We analyzed data from the National Registry of Myocardial Infarction to determine the relation between the number of patients receiving reperfusion therapy (primary angioplasty or thrombolytic therapy) and subsequent in-hospital mortality. A total of 450 hospitals were divided into quartiles according to the volume of primary angioplasty. Multiple logistic-regression models were used to determine whether the volume of primary angioplasty procedures was an independent predictor of in-hospital mortality among patients undergoing this procedure. Similar analyses were performed for patients receiving thrombolytic therapy at 516 hospitals. RESULTS: In-hospital mortality was 28 percent lower among patients who underwent primary angioplasty at hospitals with the highest volume than among those who underwent angioplasty at hospitals with the lowest volume (adjusted relative risk, 0.72; 95 percent confidence interval, 0.60 to 0.87; P<0.001). This lower rate, which represented 2.0 fewer deaths per 100 patients treated, was independent of the total volume of patients with myocardial infarction at each hospital, year of admission, and use or nonuse of adjunctive pharmacologic therapies. There was no significant relation between the volume of thrombolytic interventions and in-hospital mortality among patients who received thrombolytic therapy (7.0 percent for patients in the highest-volume hospitals vs. 6.9 percent for those in the lowest-volume hospitals, P=0.36). CONCLUSIONS: Among hospitals in the United States that have full interventional capabilities, a higher ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | Link to Article in PubMed; http://content.nejm.org/cgi/content/abstract/342/21/1573Test; N Engl J Med. 2000 May 25;342(21):1573-80.; 0028-4793 (Linking); http://hdl.handle.net/20.500.14038/46759Test; https://escholarship.umassmed.edu/qhs_pp/122Test; 1287867; qhs_pp/122 |
| الإتاحة: | https://doi.org/20.500.14038/46759Test https://hdl.handle.net/20.500.14038/46759Test https://escholarship.umassmed.edu/qhs_pp/122Test |
| حقوق: | Copyright © 2000 Massachusetts Medical Society. PDF posted as allowed by the publisher’s Author Permissions policy at https://www.nejm.org/author-center/permissionsTest. |
| رقم الانضمام: | edsbas.47CA6507 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |