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Titolo:
Volume-outcome relation for physicians and hospitals performing angioplasty for acute myocardial infarction in New York State
Autore:
Vakili, BA; Kaplan, R; Brown, DL;
Indirizzi:
Albert Einstein Coll Med, Montefiore Med Ctr, Div Cardiovasc Med, Dept MedCardiovasc Med Epidemiol & Social Med, Bronx, NY 10461 USA Albert Einstein Coll Med Bronx NY USA 10461 cial Med, Bronx, NY 10461 USA
Titolo Testata:
CIRCULATION
fascicolo: 18, volume: 104, anno: 2001,
pagine: 2171 - 2176
SICI:
0009-7322(20011030)104:18<2171:VRFPAH>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSLUMINAL CORONARY ANGIOPLASTY; OPERATOR VOLUME; TERM MORTALITY; INTERVENTIONS; EXPERIENCE; TIME;
Keywords:
angioplasty; risk factors; mortality; catheters;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Brown, DL Albert Einstein Coll Med, Montefiore Med Ctr, Div Cardiovasc Med, Dept MedCardiovasc Med Epidemiol & Social Med, 1825 Eastchester Rd, Bronx, NY 10461 USA Albert Einstein Coll Med 1825 Eastchester Rd Bronx NY USA 10461
Citazione:
B.A. Vakili et al., "Volume-outcome relation for physicians and hospitals performing angioplasty for acute myocardial infarction in New York State", CIRCULATION, 104(18), 2001, pp. 2171-2176

Abstract

Background-An inverse relation exists between the number of coronary angioplasty procedures performed by physicians or hospitals and short-term mortality. It is not known, however, whether a similar relation holds for physicians and hospitals that perform primary angioplasty for acute myocardial infarction. Methods and Results-We analyzed data from the 1995 New York State CoronaryAngioplasty Reporting System Registry to determine the relation between the number of primary angioplasty procedures performed by physicians and hospitals and in-hospital mortality. Patients who underwent angioplasty procedures within 23 hours of onset of acute myocardial infarction without preceding thrombolytic therapy were included (n = 1342). In-hospital mortality wasreduced 57% among patients who underwent primary angioplasty by high-volume as opposed to low-volume physicians (adjusted relative risk 0.43; 95% Cl 0.21 to 0.83). When patients with acute myocardial infarction were treated with primary angioplasty in high-volume hospitals rather than low-volume institutions, the relative risk reduction for in-hospital mortality was 44% (adjusted relative risk 0.56; 95% C-I 0.29 to 1.1). Compared with patients treated at low-volume hospitals by low-volume physicians, patients treated at high-volume hospitals by high-volume physicians had a 49% reduction in the risk of in-hospital mortality (adjusted relative risk 0.51; 95% Cl 0.26 to 0.99). Conclusions-Among hospitals in New York State, a higher volume of primary angioplasty procedures performed by physicians and/or hospitals was associated with a lower mortality rate.

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Documento generato il 07/04/20 alle ore 23:09:40