Table 1.
Associations of patient, arrival, discharge and hospital characteristics with prescription of discharge medication in univariable generalized linear mixed models (N = 2471)
| Variable | n (%) | Incomplete guideline adherence (n = 763) | Guideline adherence (n = 1708) | P-valuea |
|---|---|---|---|---|
| Discharge diagnosis | ***< 0.001 | |||
| STEMI | 910 (36.8 %) | 161 (21.1 %) | 749 (43.9 %) | |
| NSTEMI | 987 (39.9 %) | 310 (40.6 %) | 677 (39.6 %) | |
| UA | 574 (23.2 %) | 292 (38.3 %) | 282 (16.5 %) | |
| Type of treatment | ***< 0.001 | |||
| Medication | 793 (32.1 %) | 355 (46.5 %) | 438 (25.6 %) | |
| PCI | 1552 (62.8 %) | 360 (47.2 %) | 1192 (69.8 %) | |
| CABG | 126 (5.1 %) | 48 (6.3 %) | 78 (4.6 %) | |
| Age in years (mean, 95 % CI) | 66.9 (66.4–67.4) | 65.9 (65.3–66.5) | 69.1 (68.1–70.0) | ***< 0.001 |
| Female | 801 (32.4 %) | 287 (37.6 %) | 514 (30.1 %) | ***< 0.001 |
| Admission | ||||
| Resuscitation | 100 (4.0 %) | 9 (1.2 %) | 91 (5.3 %) | ***< 0.001 |
| Heart failure on arrival | 138 (5.6 %) | 35 (4.6 %) | 103 (6.0 %) | 0.29 |
| Cardiogenic shock on arrival | 35 (1.4 %) | 11 (1.4 %) | 24 (1.4 %) | 0.79 |
| Transportation from another hospital | 394 (15.9 %) | 97 (12.7 %) | 297 (17.4 %) | **0.002 |
| Discharge | ||||
| Month of discharge | N/A | N/A | N/A | 0.22 |
| Weekend discharge | 724 (29.3 %) | 226 (29.6 %) | 498 (29.2 %) | 0.85 |
| Length of stay (median days, 1st-3rd quartile)b | 5 (3–7) | 5 (4–7) | 4 (3–6) | ***< 0.001 |
| Risk factors | ||||
| Diabetes mellitus | 545 (22.1 %) | 118 (15.5 %) | 427 (25.0 %) | ***< 0.001 |
| Hypertension | 1204 (48.7 %) | 389 (51.0 %) | 815 (47.7 %) | 0.10 |
| Kidney failure | 111 (4.5 %) | 22 (2.9 %) | 89 (5.2 %) | *0.02 |
| Chronic heart failure | 103 (4.2 %) | 31 (4.1 %) | 72 (4.2 %) | 0.61 |
| Positive family history | 910 (36.8 %) | 281 (36.8 %) | 629 (36.8 %) | 0.64 |
| Coronary stenosis | 205 (8.3 %) | 79 (10.4 %) | 126 (7.4 %) | **0.003 |
| Hyperlipidaemiac | 1208 (48.9 %) | 375 (49.1 %) | 833 (48.8 %) | 0.61 |
| Obesity (BMI > 30 kg/m2) | 270 (10.9 %) | 80 (10.5 %) | 190 (11.1 %) | 0.64 |
| Smoker | 739 (29.9 %) | 184 (24.1 %) | 555 (32.5 %) | ***< 0.001 |
| Former smoker | 452 (18.3 %) | 138 (18.1 %) | 314 (18.4 %) | 0.99 |
| Cardiac medical history | ||||
| Angina pectoris | 442 (17.9 %) | 167 (21.9 %) | 275 (16.1 %) | **0.001 |
| Peripheral vascular disease | 159 (6.4 %) | 50 (6.6 %) | 109 (6.4 %) | 0.69 |
| Coronary artery disease | 264 (10.7 %) | 96 (12.6 %) | 168 (9.8 %) | *0.03 |
| Prior MI | 574 (23.2 %) | 189 (24.8 %) | 385 (22.5 %) | 0.21 |
| Prior PCI | 592 (24.0 %) | 206 (27.0 %) | 386 (22.6 %) | *0.02 |
| Prior CABG | 303 (12.3 %) | 125 (16.4 %) | 178 (10.4 %) | ***< 0.001 |
| Recent PCI, CABG or MI (< 6 months before admission) | 142 (5.7 %) | 42 (5.5 %) | 100 (5.9 %) | 0.51 |
| Hospital characteristics | ||||
| Type of hospital | 0.26 | |||
| General hospital (n = 4) | 648 (26.2 %) | 245 (32.1 %) | 403 (23.6 %) | |
| Tertiary teaching hospital (n = 7) | 1426 (57.7 %) | 430 (56.4 %) | 996 (58.3 %) | |
| Academic hospital (n = 2) | 397 (16.1 %) | 88 (11.5 %) | 309 (18.1 %) | |
| Treated in hospital with PCI facilities (n = 7) | 1512 (61.2 %) | 448 (58.7 %) | 1064 (62.3 %) | 0.73 |
| Treated in hospital with CABG facilities (n = 5) | 958 (38.8 %) | 290 (38.0 %) | 668 (39.1 %) | 0.87 |
*significant at ≤ 0.05 level; **significant at ≤ 0.01 level; ***significant at ≤ 0.001 level
STEMI ST-segment elevation myocardial infarction, NSTEMI non-ST-segment elevation myocardial infarction, UA unstable angina pectoris, PCI percutaneous coronary intervention, CABG coronary artery bypass grafting, CI confidence interval, N/A not applicable, BMI body mass index, MI myocardial infarction
aP-values are calculated using the Wald statistic, comparing the model fit of a generalized linear mixed model with and without the variable, corrected for clustering of patients in hospitals
bLength of stay was log-transformed after careful consideration of the residuals of a model without random intercept
cHyperlipidaemia was defined as described in patients history or statin use before admission