Clinical predictors easily obtained at presentation predict resource utilization in unstable angina.
Objective To determine if a risk prediction model for patients with unstable angina would predict resource utilization.
Methods and Results Four hundred sixty-five consecutive patients admitted for unstable angina to a tertiary care university-based medical center were prospectively evaluated from June 1,1992, to June 30,1995.
The proportion of patients receiving coronary angiography, coronary angioplasty, and coronary artery bypass grafting were analyzed according to four risk groups on the basis of a previously published model :
Group 1,<2% risk of major complication ;
Group 2,2.1% to 5% risk ;
Group 3,5.1% to 15% risk ;
and Group 4,>15.1% risk.
Hospital length of stay and estimated cost of hospitalization based on DRG and specific payer ratio of cost-to-charge were also compared between groups.
Multiple linear regression analysis was used to determine the influence of estimated risk and procedures on hospital costs.
The four groups were well matched for gender, hypertension, tobacco history, and previous percutaneous transluminal coronary angioplasty and myocardial infarction.
Group 4 had a higher incidence of previous coronary bypass grafting (35% vs 10%, p=0.001) and triple vessel or left main coronary artery disease compared with Group 1 (44% vs 13%, P=0.041).
Group 4 patients were more likely to be admitted to the coronary care unit compared with Group 2 or Group 1 patients (80% vs Group 1 : 51% [p=0.001] ; and vs Group 2 : 53% [p=0. (...)
Mots-clés Pascal : Angor instable, Modèle statistique, Analyse risque, Traitement, Exploration, Coût, Hospitalisation, Economie santé, Gestion ressources, Appareil circulatoire pathologie, Cardiopathie coronaire
Mots-clés Pascal anglais : Variant angina, Statistical model, Risk analysis, Treatment, Exploration, Costs, Hospitalization, Health economy, Resource management, Cardiovascular disease, Coronary heart disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0432889
Code Inist : 002B12A03. Création : 25/01/1999.