Hospitals that fail to follow treatment guidelines for heart attack patients have nearly twice the death rate of hospitals that adhere to a series of clinical practices proved effective in clinical trials, according to a study by cardiologists at Duke University Medical Center. The study "underscores the importance of following clinical-practice guidelines to improve patient outcomes," said Eric Peterson, M.D., one of the study's authors. Those practices include the use of specific drugs and procedures within 24 hours, such as administration of aspirin, blood thinners and heart medications called beta-blockers and ACE inhibitors. In a review of 250,000 patients who suffered a heart attack from June 2000 through June 2002, researchers found that the death rate at hospitals that best follow the guidelines was 8% compared with 15% for the hospitals least likely to adhere to the established protocols. "Even for well-accepted treatments, such as giving beta-blockers within the first 24 hours of a heart attack, patients treated at lagging hospitals have only a 50-50 chance of getting the drugs," Peterson said. "In contrast, at leading U.S. centers, nearly 82% of patients were given beta-blockers. This degree of variation seems unacceptable." -- John Morrissey
Treatment guidelines essential for heart patients
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