Skip to main content
PMC home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1987 May 2;294(6580):1121–1125. doi: 10.1136/bmj.294.6580.1121

Mortality from myocardial infarction in different types of hospitals.

R Reznik, I Ring, P Fletcher, G Berry
PMCID: PMC1246285  PMID: 3107722

Abstract

Hospitals ranging from large urban teaching hospitals to small country hospitals were stratified into four levels of care and examined for their effectiveness of coronary care in relation to these levels. The crude hospital mortality among 2265 patients admitted for definite or possible acute myocardial infarction was 21% at level 1 (the most elaborate level), 22% at level 2, 21% at level 3, and 19% at level 4 (the least elaborate). Adjustment for age or other prognostic factors produced no significant differences across levels either for coronary care unit care or for combined coronary unit and ward care. Success in resuscitation was also similar across levels. These findings suggest that increased resources for coronary care units--whether for new services or for upgrading existing ones--may not be required.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bain C., Siskind V., Neilson G. Site of care and survival after acute myocardial infarction. Med J Aust. 1981 Aug 22;2(4):185–188. [PubMed] [Google Scholar]
  2. Bloom B. S., Peterson O. L. End results, cost and productivity of coronary-care units. N Engl J Med. 1973 Jan 11;288(2):72–78. doi: 10.1056/NEJM197301112880205. [DOI] [PubMed] [Google Scholar]
  3. Casagrande J. T., Pike M. C. An improved approximate formula for calculating sample sizes for comparing two binomial distributions. Biometrics. 1978 Sep;34(3):483–486. [PubMed] [Google Scholar]
  4. Christiansen I., Iversen K., Skouby A. P. Benefits obtained by the introduction of a coronary-care unit. A comparative study. Acta Med Scand. 1971 Apr;189(4):285–291. doi: 10.1111/j.0954-6820.1971.tb04377.x. [DOI] [PubMed] [Google Scholar]
  5. Goldman L., Cook F., Hashimotso B., Stone P., Muller J., Loscalzo A. Evidence that hospital care for acute myocardial infarction has not contributed to the decline in coronary mortality between 1973-1974 and 1978-1979. Circulation. 1982 May;65(5):936–942. doi: 10.1161/01.cir.65.5.936. [DOI] [PubMed] [Google Scholar]
  6. Goldman L. Coronary care units. A perspective on their epidemiologic impact. Int J Cardiol. 1982;2(2):284–287. doi: 10.1016/0167-5273(82)90046-8. [DOI] [PubMed] [Google Scholar]
  7. Gordis L., Naggan L., Tonascia J. Pitfalls in evaluating the impact of coronary care units on mortality from myocardial infarctions. Johns Hopkins Med J. 1977 Dec;141(6):287–295. [PubMed] [Google Scholar]
  8. Hill J. D., Holdstock G., Hampton J. R. Comparison of mortality of patients with heart attacks admitted to a coronary care unit and an ordinary medical ward. Br Med J. 1977 Jul 9;2(6079):81–83. doi: 10.1136/bmj.2.6079.81. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Mather H. G., Morgan D. C., Pearson N. G., Read K. L., Shaw D. B., Steed G. R., Thorne M. G., Lawrence C. J., Riley I. S. Myocardial infarction: a comparison between home and hospital care for patients. Br Med J. 1976 Apr 17;1(6015):925–929. doi: 10.1136/bmj.1.6015.925. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Mather H. G., Pearson N. G., Read K. L., Shaw D. B., Steed G. R., Thorne M. G., Jones S., Guerrier C. J., Eraut C. D., McHugh P. M. Acute myocardial infarction: home and hospital treatment. Br Med J. 1971 Aug 7;3(5770):334–338. doi: 10.1136/bmj.3.5770.334. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Norris R. M., Brandt P. W., Caughey D. E., Lee A. J., Scott P. J. A new coronary prognostic index. Lancet. 1969 Feb 8;1(7589):274–278. doi: 10.1016/s0140-6736(69)91035-6. [DOI] [PubMed] [Google Scholar]
  12. O'Rourke M. F., Walsh B., Fletcher M., Crowley A. Impact of the new generation coronary care unit. Br Med J. 1976 Oct 9;2(6040):837–839. doi: 10.1136/bmj.2.6040.837. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Peel A. A., Semple T., Wang I., Lancaster W. M., Dall J. L. A CORONARY PROGNOSTIC INDEX FOR GRADING THE SEVERITY OF INFARCTION. Br Heart J. 1962 Nov;24(6):745–760. doi: 10.1136/hrt.24.6.745. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Pozen M. W., D'Agostino R. B., Mitchell J. B., Rosenfeld D. M., Guglielmino J. T., Schwartz M. L., Teebagy N., Valentine J. M., Hood W. B., Jr The usefulness of a predictive instrument to reduce inappropriate admissions to the coronary care unit. Ann Intern Med. 1980 Feb;92(2 Pt 1):238–242. doi: 10.7326/0003-4819-92-2-238. [DOI] [PubMed] [Google Scholar]
  15. Rawles J. M., Kenmure A. C. The coronary care controversy. Br Med J. 1980 Sep 20;281(6243):783–786. doi: 10.1136/bmj.281.6243.783. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES