The association between hospital volume and survival after acute myocardial infarction in elderly patients

David Ross Thiemann, Josef Coresh, William J. Oetgen, Neil R. Powe

Research output: Contribution to journalArticle

Abstract

Background: Patients with chest pain thought to be due to acute coronary ischemia are typically taken by ambulance to the nearest hospital. The potential benefit of field triage directly to a hospital that treats a large number of patients with myocardial infarction is unknown. Methods We conducted a retrospective cohort study of the relation between the number of Medicare patients with myocardial infarction that each hospital in the study treated (hospital volume) and long-term survival among 98,898 Medicare patients 65 years of age or older. We used proportional-hazards methods to adjust for clinical, demographic, and health-system-related variables, including the availability of invasive procedures, the specialty of the attending physician, and the area of residence of the patient (rural, urban, or metropolitan). Results The patients in the quartile admitted to hospitals with the lowest volume were 17 percent more likely to die within 30 days after admission than patients in the quartile admitted to hospitals with the highest volume (hazard ratio, 1.17; 95 percent confidence interval, 1.09 to 1.26; P

Original languageEnglish (US)
Pages (from-to)1640-1648
Number of pages9
JournalNew England Journal of Medicine
Volume340
Issue number21
DOIs
StatePublished - May 27 1999

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Myocardial Infarction
Survival
Medicare
Low-Volume Hospitals
High-Volume Hospitals
Ambulances
Triage
Patient Admission
Chest Pain
Cohort Studies
Ischemia
Retrospective Studies
Demography
Confidence Intervals
Physicians
Health

ASJC Scopus subject areas

  • Medicine(all)

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The association between hospital volume and survival after acute myocardial infarction in elderly patients. / Thiemann, David Ross; Coresh, Josef; Oetgen, William J.; Powe, Neil R.

In: New England Journal of Medicine, Vol. 340, No. 21, 27.05.1999, p. 1640-1648.

Research output: Contribution to journalArticle

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