Specifically, hospitals that were the best at following nine different treatments recommended by the American College of Cardiology (ACC) and the American Heart Association (AHA) had a mortality rate of 4.15 percent, compared with a 6.31 percent mortality rate for hospitals that were the worst at following guidelines. Additionally, every 10 percent improvement in guideline adherence led to a 10 percent decline in mortality, the researchers found.
These findings are important, they continued, because while many studies have proven the effectiveness of individual therapies in improving outcomes for heart attack patients, few have correlated individual hospitals' combined use of these different therapies with how their patients actually fare.
"While we found modest correlation between use of the individual treatments and improved mortality, when we looked at all nine treatments together, we found a significant association between adherence and improved mortality," said lead investigator Eric Peterson, M.D., a cardiologist at the Duke Clinical Research Institute. The researchers published their findings on April 26, 2006, in the Journal of the American Medical Association.
"Importantly, adherence to proven guidelines may serve as a marker for the overall culture of the hospital and its commitment to providing the best possible care," Peterson continued. "The performance of these hospitals on the measurements we used may indirectly reflect the hospital's overall culture, business practices and clinical skills."
Both the ACC and the AHA have issued guidelines for optimal care of patients who arrive at a hospital with symptoms of a possible heart attack,
Contact: Richard Merritt
Duke University Medical Center