Background Previous studies have documented the strong association between availability of on-site cardiac catheterization facilities and increased use of coronary angiography in patients with acute myocardial infarction (AMI).
Although these studies have shown little influence of the availability of catheterization labs on hospital mortality, no long-term follow-up has been reported.
Methods and Results From a cohort of 12 331 AMI patients admitted to 19 Seattle area hospitals, we compared long-term outcome in 7985 patients admitted to hospitals with and 4346 patients admitted to hospitals without on-site catheterization labs.
During the index hospitalization, patients admitted to hospitals with on-site catheterization were more likely to undergo coronary angiography (67.1% versus 39.3%, P<. 0001), coronary angioplasty (32.5% versus 13.2%, P<, 0001), or coronary bypass surgery (12.5% versus 9.5%, P<. 0001).
At 3-year follow-up, patients admitted to hospitals with on-site catheterization labs were more likely to undergo postdischarge angiography (19.2% versus 15.2% : P=0001) and coronary angioplasty (11.6% versus 8.2%, P<. 0001).
This was associated with approximately $2500.00 per patient in higher cumulative costs.
Despite this higher rate of procedure use, there was no association between admission to a hospital with on-site catheterization facilities and lower long-term mortality (multivariate hazard ratio, 1.0 ; 95% Cl, 0.93 to 1.1. (...)
Mots-clés Pascal : Infarctus, Myocarde, Aigu, Cathétérisme, Hospitalisation, Analyse coût efficacité, Economie santé, Survie, Exploration, Traitement, Pronostic, Homme, Etude longitudinale, Etude comparative, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie
Mots-clés Pascal anglais : Infarct, Myocardium, Acute, Catheterization, Hospitalization, Cost efficiency analysis, Health economy, Survival, Exploration, Treatment, Prognosis, Human, Follow up study, Comparative study, Cardiovascular disease, Coronary heart disease, Myocardial disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0500583
Code Inist : 002B12A03. Création : 13/02/1998.