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• W4238039701 abstract "Background: We describe all cause mortality 18 months after comprehensive 14-day audits in 2002 and 2007 in all NZ hospitals admitting ACS patients. Methods: All cause mortality was extracted to December 2008 from the national register. Eighty percent patients had a discharge diagnosis of ACS (2002: 721/930 pts; 2007: 828/1003 pts). Cox proportional hazards models (SAS v 9.2) were fitted and assumptions verified. Propensity scores were calculated as the predicted probability of being admitted to an intervention centre (IC) or non-IC from baseline variables, and used to adjust for imbalance in risk between IC and non-IC. Results: Eighteen months after an ACS admission in 2002, 14% of patients had died (10% IC (n = 25/251), 16% non-IC (n = 73/470), p = 0.040). This persisted after adjustments (Table 1). However 18 months after an ACS admission in 2007, 10% patients had died, without a difference between Centres (10% % IC (n = 41/376), 10% non-IC (n = 44/452), p = 0.65). Patients admitted to a non-IC during the 2002 audit were less likely to have an angiogram than those admitted to an IC (14% vs 37%, p < 0.0001). Similar rates of angiography (37% vs 33%, p = 0.3) were noted in 2007.Table 1Proportional Hazard of all Cause Death within 18 Months of an ACS Admission to an IC (the Non-IC is Referent with a Proportional Hazard of 1 in Each Audit).2002Unadjusted0.70 (0.48, 1.01)p = 0.059Adj. for age/sex0.67 (0.46, 0.98)p = 0.040Adj. propensity score0.65 (0.43, 0.96)p = 0.0312007Unadjusted0.87 (0.59, 1.26)p = 0.45Adj. for age/sex0.96 (0.65, 1.41)p = 0.84Adj. propensity score0.94 (0.63, 1.41)p = 0.77 Open table in a new tab Conclusion: Following an ACS admission in 2002, 18 month all cause mortality was 35% higher for patients admitted to a non-IC, compared with those admitted to an IC. With a modest increase in angiography between 2002 and 2007, a clear improvement was noted in mortality. This suggests that access to cardiac angiography, with subsequent revascularisation, at least in part explains the improved outcomes seen in non-IC in 2007." @default.
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• W4238039701 date "2012-01-01" @default.
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• W4238039701 title "Is the Mortality Risk Following an Acute Coronary Syndrome (ACS) Admission to a Non-Intervention Centre Related to Access to Cardiac Angiography? 18 Month Follow-Up of the 2002/2007 New Zealand (NZ) ACS Audits" @default.
• W4238039701 doi "https://doi.org/10.1016/j.hlc.2012.05.625" @default.
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