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Titolo:
Validating recommendations for coronary angiography following acute myocardial infarction in the elderly: A matched analysis using propensity scores
Autore:
Normand, SLT; Landrum, NB; Guadagnoli, E; Ayanian, JZ; Ryan, TJ; Cleary, PD; McNeil, BJ;
Indirizzi:
Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA HarvardUniv Boston MA USA 02115 t Hlth Care Policy, Boston, MA 02115 USA Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 Hlth, Dept Biostat, Boston, MA 02115 USA Harvard Univ, Sch Publ Hlth, Dept Social Med, Boston, MA 02115 USA HarvardUniv Boston MA USA 02115 h, Dept Social Med, Boston, MA 02115 USA Boston Univ, Sch Med, Boston, MA 02118 USA Boston Univ Boston MA USA 02118 oston Univ, Sch Med, Boston, MA 02118 USA Brigham & Womens Hosp, Dept Med, Div Gen Med, Boston, MA 02115 USA Brigham& Womens Hosp Boston MA USA 02115 v Gen Med, Boston, MA 02115 USA Brigham & Womens Hosp, Dept Radiol, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 pt Radiol, Boston, MA 02115 USA
Titolo Testata:
JOURNAL OF CLINICAL EPIDEMIOLOGY
fascicolo: 4, volume: 54, anno: 2001,
pagine: 387 - 398
SICI:
0895-4356(200104)54:4<387:VRFCAF>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
COOPERATIVE CARDIOVASCULAR PROJECT; BYPASS GRAFT-SURGERY; NEW-YORK-STATE; CARDIAC PROCEDURES; MEDICARE PATIENTS; APPROPRIATENESS; OUTCOMES; CARE; THROMBOLYSIS; ASSOCIATION;
Keywords:
AMI; coronary angiography; practice guidelines; clinical indication; propensity score; caliper matching;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Normand, SLT Harvard Univ, Sch Med, Dept Hlth Care Policy, 180 Longwood Ave, Boston, MA02115 USA Harvard Univ 180 Longwood Ave Boston MA USA 02115 MA02115 USA
Citazione:
S.L.T. Normand et al., "Validating recommendations for coronary angiography following acute myocardial infarction in the elderly: A matched analysis using propensity scores", J CLIN EPID, 54(4), 2001, pp. 387-398

Abstract

We determined whether adherence to recommendations for coronary angiography more than 12 h after symptom onset but prior to hospital discharge after acute myocardial infarction (AMI) resulted in better survival. Using propensity scores, we created a matched retrospective sample of 19,568 Medicare patients hospitalized with AMI during 1994-1995 in the United States. Twenty-nine percent, 36%, and 34% of patients were judged necessary, appropriate,or uncertain, respectively, for angiography while 60% of those judged necessary received the procedure during the hospitalization. The 3-year survival benefit was largest for patients rated necessary [mean survival difference (95% CI): 17.6% (15.1, 20.1)] and smallest for those rated uncertain [8.8% (6.8, 10.7)]. Angiography recommendations appear to select patients who are likely to benefit from the procedure and the consequent interventions. Because of the magnitude of the benefit and of the number of patients involved, steps should be taken to replicate these findings. (C) 2001 Elsevier Science Inc. All rights reserved.

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Documento generato il 19/01/20 alle ore 08:58:49