François Schiele1, Chris P Gale2, Tabassome Simon2, Keith A A Fox2, Hector Bueno2, Maddalena Lettino2, Marco Tubaro2, Etienne Puymirat2, Jean Ferrières2, Nicolas Meneveau2, Nicolas Danchin2. 1. From the Department of Cardiology, University Hospital of Besancon, EA3920 University of Franche-Comté, France (F.S., N.M.); Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, and York Teaching Hospital NHS Foundation Trust, United Kingdom (C.P.G.); Department of Clinical Pharmacology, Unite de Recherche Clinique de l'Est Parisien, Assistance Publique-Hôpitaux de Paris, Saint Antoine Hospital, France; Université Pierre et Marie Curie, Paris, France (T.S.); Centre for Cardiovascular Science, University and Royal Infirmary of Edinburgh, United Kingdom (K.A.A.F.); Centro Nacional de Investigaciones Cardiovasculares (CNIC), Cardiology Department, Hospital Universitario 12 de Octubre, and Universidad Complutense de Madrid, Spain (H.B.); Cardiovascular Department, Humanitas Research Hospital, Milan, Italy (M.L.); Department of Cardiology, Ospedale San Filippo Neri, Rome, Italy (M.T.); Assistance Publique-Hôpitaux de Paris (AP-HP); Hôpital Européen Georges Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France (E.P., N.D.); and Department of Cardiology, Toulouse University School of Medicine, Rangueil Hospital, France (J.F.). francois.schiele@Univ-fcomte.fr. 2. From the Department of Cardiology, University Hospital of Besancon, EA3920 University of Franche-Comté, France (F.S., N.M.); Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, and York Teaching Hospital NHS Foundation Trust, United Kingdom (C.P.G.); Department of Clinical Pharmacology, Unite de Recherche Clinique de l'Est Parisien, Assistance Publique-Hôpitaux de Paris, Saint Antoine Hospital, France; Université Pierre et Marie Curie, Paris, France (T.S.); Centre for Cardiovascular Science, University and Royal Infirmary of Edinburgh, United Kingdom (K.A.A.F.); Centro Nacional de Investigaciones Cardiovasculares (CNIC), Cardiology Department, Hospital Universitario 12 de Octubre, and Universidad Complutense de Madrid, Spain (H.B.); Cardiovascular Department, Humanitas Research Hospital, Milan, Italy (M.L.); Department of Cardiology, Ospedale San Filippo Neri, Rome, Italy (M.T.); Assistance Publique-Hôpitaux de Paris (AP-HP); Hôpital Européen Georges Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France (E.P., N.D.); and Department of Cardiology, Toulouse University School of Medicine, Rangueil Hospital, France (J.F.).
Abstract
BACKGROUND: The Acute Cardiovascular Care Association defined quality indicators (QIs) for the management of acute myocardial infarction. The application of these QIs to existing databases is appealing. It remains to be determined what the rates of implementation are, how the QIs are related to long-term survival, and whether quality categorization is possible. METHODS AND RESULTS: The QIs were extracted from the French nationwide registries French Registry of Acute ST-Elevation or Non-ST-Elevation Myocardial Infarction (FAST-MI) 2005 (n=3670) and FAST-MI 2010 (n=4169). Implementation rates for each QI are reported for both cohorts. The composite QI was used for benchmarking, and the relationship between QIs and 3-year survival was determined using a Cox model. In FAST-MI 2010, 12 individual and 2 composite QIs could be assessed. Four QIs were not recorded in FAST-MI 2010 and 4 in 2005, either because of treatment nonavailability or because of data not recorded. The degree of implementation ranged from 12% to 89%, with higher rates in 2010 as compared with 2005. Seven individual QIs were associated with survival, and there was a significant and gradual association between survival and categories of the composite QI. Center categorization was possible in 26% to 30% of participating centers; 16 (27%) centers in 2005 and 14 (20%) in 2010 were categorized as low quality. CONCLUSIONS: Twelve of 17 individual QIs could be assessed from FAST-MI 2010. The composite QI was significantly associated with 3-year survival and distinguished centers with high, average, and low quality of care.
BACKGROUND: The Acute Cardiovascular Care Association defined quality indicators (QIs) for the management of acute myocardial infarction. The application of these QIs to existing databases is appealing. It remains to be determined what the rates of implementation are, how the QIs are related to long-term survival, and whether quality categorization is possible. METHODS AND RESULTS: The QIs were extracted from the French nationwide registries French Registry of Acute ST-Elevation or Non-ST-Elevation Myocardial Infarction (FAST-MI) 2005 (n=3670) and FAST-MI 2010 (n=4169). Implementation rates for each QI are reported for both cohorts. The composite QI was used for benchmarking, and the relationship between QIs and 3-year survival was determined using a Cox model. In FAST-MI 2010, 12 individual and 2 composite QIs could be assessed. Four QIs were not recorded in FAST-MI 2010 and 4 in 2005, either because of treatment nonavailability or because of data not recorded. The degree of implementation ranged from 12% to 89%, with higher rates in 2010 as compared with 2005. Seven individual QIs were associated with survival, and there was a significant and gradual association between survival and categories of the composite QI. Center categorization was possible in 26% to 30% of participating centers; 16 (27%) centers in 2005 and 14 (20%) in 2010 were categorized as low quality. CONCLUSIONS: Twelve of 17 individual QIs could be assessed from FAST-MI 2010. The composite QI was significantly associated with 3-year survival and distinguished centers with high, average, and low quality of care.
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Authors: Marlous Hall; Owen J Bebb; Tatandashe B Dondo; Andrew T Yan; Shaun G Goodman; Hector Bueno; Derek P Chew; David Brieger; Philip D Batin; Michel E Farkouh; Harry Hemingway; Adam Timmis; Keith A A Fox; Chris P Gale Journal: Eur Heart J Date: 2018-11-07 Impact factor: 35.855