Circ Cardiovasc Qual
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Circ Cardiovasc Qual · Nov 2009
ST-elevation myocardial infarction: which patients do quality assurance programs include?
In the United States, efforts are underway to improve timely access to percutaneous coronary intervention in ST-elevation myocardial infarction (STEMI). The Joint Commission (TJC) and the American College of Cardiology National Cardiovascular Data Registry (NCDR) have developed standardized definitions and clinical performance measures for STEMI. The purpose of this study was to determine differences in 3 quality-assurance registries for STEMI patients. ⋯ Current inclusion criteria for enrollment in STEMI registries are not uniform. This may lead to variable quality assurance outcomes for the same patient cohort and has important implications for standardized quality measurement.
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Circ Cardiovasc Qual · Nov 2009
Effect of endovascular aneurysm repair on the volume-outcome relationship in aneurysm repair.
We aim to quantify the relationship between the annual caseload (volume) and outcome from elective endovascular (EVR) or open repair of abdominal aortic aneurysms (AAAs) in England between 2005 and 2007. ⋯ A strong relationship existed between the volume of surgery performed and outcome from both open and endovascular aneurysm repairs. These data support the concept that abdominal aortic surgery should be performed in specialized units that meet a minimum volume threshold.
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Circ Cardiovasc Qual · Nov 2009
Outcomes among patients with ST-segment-elevation myocardial infarction presenting to interventional hospitals with and without on-site cardiac surgery.
Primary percutaneous coronary intervention (pPCI) is the preferred reperfusion strategy for patients with ST-segment-elevation myocardial infarction (STEMI). The quality of care and safety and efficacy of pPCI at hospitals without on-site open heart surgery (No-OHS hospitals) remains an area of active investigation. ⋯ STEMI patients presenting to No-OHS hospitals have substantially higher mortality, are less likely to receive guideline recommended medications within 24 hours, and are less likely to undergo acute reperfusion therapy, although this difference was of borderline significance after adjusting for hospital and treatment variables. There was no difference in mortality among patients undergoing pPCI.
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Circ Cardiovasc Qual · Nov 2009
Randomized Controlled Trial Multicenter StudyA randomized clinical trial to reduce patient prehospital delay to treatment in acute coronary syndrome.
Delay from onset of acute coronary syndrome (ACS) symptoms to hospital admission continues to be prolonged. To date, community education campaigns on the topic have had disappointing results. Therefore, we conducted a clinical randomized trial to test whether an intervention tailored specifically for patients with ACS and delivered one-on-one would reduce prehospital delay time. ⋯ clinicaltrials.gov. Identifier NCT00734760.