International journal of cardiology
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Multicenter Study
Provider profiling models for acute coronary syndrome mortality using administrative data.
Administrative data have been used to construct risk-adjustment models for provider profiling to benchmark hospital performance for acute myocardial infarction (AMI), but much less for acute coronary syndrome (ACS). We assess the impact on risk model performance and hospital-level mortality rate ratios (SMRs) of three key issues: comorbidity measurement methods, inter-hospital transfers and post-discharge deaths. ⋯ Models for comparing hospitals' ACS mortality can be constructed with good discrimination using English administrative hospital data. Adjusting for transfers in and capturing post-discharge deaths are more important than the choice of comorbidity adjustment.
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The aim of the study is to design a specific Intensive Care Unit length-of-stay risk model based on the preoperative factors and surgeries utilizing modeling strategies for time-to-event data in a prospective observational clinical study. ⋯ ICU-LOS can be predicted by preoperative data and type of surgeries. The derived ICU-LOS prediction model is dynamic and most predictors have an effect that decreases with time. The algorithm can preoperatively predict ICU-LOS curves and could have a major role in the decision making-behavior of clinicians, resources' allocation and maximization of care for high-risk patients.
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Atrial fibrillation (AF) is the commonest sustained cardiac arrhythmia. In developing countries, AF is a growing public health problem with the epidemiologic transition from communicable to non-communicable diseases. However, relatively little is known about AF in the developing world. The aim of this review is to examine in developing countries the prevalence, associated medical conditions and management of AF. ⋯ The limited studies available suggest that in the developing world there is a significant prevalence of AF, which is predominantly associated with hypertension and valvular heart disease, and carries a risk of stroke. Highly variable use of anticoagulants may be related to different health care and socioeconomic settings. More studies are needed to improve understanding of the epidemiology and management of AF in developing countries.
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Lower extremity peripheral arterial disease (LE-PAD) reduces walking capacity and is associated with an increased cardiovascular risk. Endovascular revascularization of LE-PAD improves walking performance and quality of life. In the present study, we determined whether successful lower limbs revascularization also impacts cardiovascular outcome in LE-PAD patients. ⋯ This study shows that successful revascularization of LE-PAD patients affected by intermittent claudication, in addition to improving functional status, reduces the occurrence of future major cardiovascular events.