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  1. Validity of criteria used for detecting underuse of coronary revascularization.

    Article - En anglais

    Objective

    - To assess criteria used for detecting underuse of coronary artery revascularization procedures in terms of patient outcomes.

    Design

    - Retrospective cohort study using medical records supplemented by a telephone survey and review of county death records.

    Setting

    - Four public hospitals and two academically affiliated private hospitals in Los Angeles County, California.

    Participants

    - A total of 671 patients who had coronary angiography between June 1,1990, and September 30,1991, and who met explicit clinical criteria for the necessity of coronary artery bypass graft (CABG) surgery or percutaneous transluminal coronary angioplasty (PTCA).

    Main Outcome Measures

    - For all patients (n=671), we estimated the association between receipt of necessary revascularization and mortality (median follow-up after angiography, 797 days) after adjusting for potential confounders.

    For the patients completing the telephone interview (n=374), we examined the relationship between receipt of necessary revascularization and frequency of chest pain.

    Results

    - Patients who received necessary revascularization within 1 year of angiography had lower mortality than those who did not (8.7% vs 15.8%, P=01), and this association persisted after adjustment for extent of coronary artery disease, clinical symptom complex, ejection fraction, and cardiac surgical risk index.

    Conclusions

    - Among patients meeting criteria for the necessity of revascularization.

    Mots-clés Pascal : Revascularisation chirurgicale, Artère coronaire, Indication, Validité, Critère, Economie santé, Epidémiologie, Homme, Amérique du Nord, Amérique, Chirurgie

    Mots-clés Pascal anglais : Surgical revascularization, Coronary artery, Indication, Validity, Criterion, Health economy, Epidemiology, Human, North America, America, Surgery

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0503857

    Code Inist : 002B30A01C. Création : 01/03/1996.