A study of nearly 65,000 patients hospitalized for acute heart problems found that outcomes of care were directly related to how well their treatment adhered to guidelines established by the American College of Cardiology and the American Heart Association. Researchers at Duke University Medical Center separated 400 participating hospitals into four quadrants according to how often they adhered to nine measures of quality for inpatient and discharge care, such as giving proper medications within 24 hours of admission and prescribing drugs such as aspirin and beta blockers at discharge. The leading 25% had a mortality rate of 4.17%, while the lowest 25% had a rate of 6.33%. The results were significant because they were recorded in the "real world" instead of in clinical trials, said Eric Peterson, lead researcher in the study. A national database of cases involving heart-related admissions, known as CASCADE, tracked "patients that physicians see every day in all types of hospitals," Peterson said. Ties between the recommended care and patient outcomes were first proven in large-scale clinical trials, but "other analyses based on clinical trials are not necessarily indicative of the population as a whole, since they usually have many different exclusion and inclusion criteria." Peterson presented the study today at the annual meeting of the American College of Cardiology in New Orleans. -- by John Morrissey
Adherence to quality measures brings better results
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