INTRODUCTION AND OBJECTIVES: Hospital registries are useful tools to measure the degree of implementation of new treatments and clinical practice guidelines. PATIENTS AND METHOD: The hospital registry described here was developed in the prospective PRIAMHO II study, which involved a random selection of Spanish hospitals with a coronary intensive care unit and external quality control. This study investigated patients admitted to the coronary care unit with acute myocardial infarction. Demographic and clinical characteristics were recorded, as well as the management, clinical course and survival after 28 days and one year. RESULTS: From May 15 to December 15 2000 we included in the registry 6,221 patients from the 58 hospitals that complied with the quality control requirements (71.6% of all participating hospitals). Acute mortality was 9.6%; 28-day and one-year mortality were 11.4% and 16.5%, respectively. Of the patients with ST elevation-myocardial infarction of less than 12 hours' duration, 71.6% were reperfused and 89.3% received fibrinolysis with a median door-to-needle time of 48 minutes. Ejection fraction was measured in 81% of the patients, and 43% were tested for inducible ischemia. About nine-tenths (91%) of the patients were discharged on least one antiplatelet drug, 56% on a beta blocker, 45% on an ACE inhibitor, and 45% on a lipid-lowering agent, with a coefficient of variation between hospitals greater than 25% for the last three drugs. CONCLUSIONS: The percentage of patients with ST elevation treated with reperfusion should increase, as it probably will thanks to the increasing use of primary angioplasty. The door-to-needle time was longer than the recommended interval. In-hospital risk stratification was good but nonsystematic for the evaluation of ejection fraction, and unsatisfactory for inducible ischemia testing. At discharge the percentages of patients receiving beta blockers, ACE inhibitors and statins were not optimal, and there were wide variations in prescribing practices between hospitals.
INTRODUCTION AND OBJECTIVES: Hospital registries are useful tools to measure the degree of implementation of new treatments and clinical practice guidelines. PATIENTS AND METHOD: The hospital registry described here was developed in the prospective PRIAMHO II study, which involved a random selection of Spanish hospitals with a coronary intensive care unit and external quality control. This study investigated patients admitted to the coronary care unit with acute myocardial infarction. Demographic and clinical characteristics were recorded, as well as the management, clinical course and survival after 28 days and one year. RESULTS: From May 15 to December 15 2000 we included in the registry 6,221 patients from the 58 hospitals that complied with the quality control requirements (71.6% of all participating hospitals). Acute mortality was 9.6%; 28-day and one-year mortality were 11.4% and 16.5%, respectively. Of the patients with ST elevation-myocardial infarction of less than 12 hours' duration, 71.6% were reperfused and 89.3% received fibrinolysis with a median door-to-needle time of 48 minutes. Ejection fraction was measured in 81% of the patients, and 43% were tested for inducible ischemia. About nine-tenths (91%) of the patients were discharged on least one antiplatelet drug, 56% on a beta blocker, 45% on an ACE inhibitor, and 45% on a lipid-lowering agent, with a coefficient of variation between hospitals greater than 25% for the last three drugs. CONCLUSIONS: The percentage of patients with ST elevation treated with reperfusion should increase, as it probably will thanks to the increasing use of primary angioplasty. The door-to-needle time was longer than the recommended interval. In-hospital risk stratification was good but nonsystematic for the evaluation of ejection fraction, and unsatisfactory for inducible ischemia testing. At discharge the percentages of patients receiving beta blockers, ACE inhibitors and statins were not optimal, and there were wide variations in prescribing practices between hospitals.
Authors: Adolfo Cabadés; José Valencia; Joaquín Rueda; Ildefonso Echánove; Rafael Sanjuán; Javier Cebrián; Enrique González-Hernández; Juan Cardona; Francisco Colomina; Mercedes Francés; Victoria Ortolá; Francisco Sogorb Journal: Int J Biomed Sci Date: 2010-06
Authors: Francisco Javier Félix-Redondo; Luis Lozano Mera; Luciano Consuegra-Sánchez; Fernando Giménez Sáez; Francisco Javier Garcipérez de Vargas; José María Castellano Vázquez; Daniel Fernández-Bergés Journal: Open Heart Date: 2016-02-26
Authors: Daniel Fernández-Bergés; Irene R Degano; Reyes Gonzalez Fernandez; Isaac Subirana; Joan Vila; Manuel Jiménez-Navarro; Silvia Perez-Fernandez; Mercé Roqué; Antoni Bayes-Genis; Francisco Fernandez-Aviles; Antonio Mayorga; Vicente Bertomeu-Gonzalez; Juan Sanchis; Marcos Rodríguez Esteban; Antonio Sanchez-Hidalgo; Esther Sanchez-Insa; Ane Elorriaga; Emad Abu Assi; Alberto Nuñez; Jose Manuel Garcia Ruiz; Pedro Morrondo Valdeolmillos; Daniel Bosch-Portell; Iñaki Lekuona; Andres Carrillo-Lopez; Alberto Zamora; Berta Vega-Hernandez; Javier Alameda Serrano; Catalina Rubert; Luis Ruiz-Valdepeñas; Laura Quintas; Luis Rodríguez-Padial; Jessica Vaquero; Luis Martinez Dolz; Jose A Barrabes; Pedro L Sanchez; Alessandro Sionis; Julio Martí-Almor; Roberto Elosua; Rosa-María Lidon; David Garcia-Dorado; Jaume Marrugat Journal: Open Heart Date: 2020-08