Optimal In-Hospital and Discharge Medical Therapy in Acute Coronary Syndromes in Kerala: Results From the Kerala Acute Coronary Syndrome Registry.
Circ Cardiovasc Qual Outcomes. 2013 Jun 25;
Authors: Huffman MD, Prabhakaran D, Abraham AK, Krishnan MN, Nambiar AC, Mohanan PP, on behalf of the Kerala Acute Coronary Syndrome Registry Investigators
BACKGROUND: test for continuous variables and χ(2) test for categorical variables. We created random effects logistic regression models to evaluate the association between Global Registry of Acute Coronary Events risk score variables and optimal in-hospital or discharge medical therapy. Optimal in-hospital and discharge medical care were delivered in 40% and 46% of admissions, respectively. Wide variability in both in-hospital and discharge medical care was present, with few hospitals reaching consistently high (>90%) levels. Patients receiving optimal in-hospital medical therapy had an adjusted odds ratio (95% confidence interval)=0.93 (0.71, 1.22) for in-hospital death and an adjusted odds ratio (95% confidence interval)=0.79 (0.63, 0.99) for major adverse cardiovascular event rates. Patients who received optimal in-hospital medical care were far more likely to receive optimal discharge care (adjusted odds ratio [95% confidence interval] = 10.48 [9.37, 11.72]).Conclusions-Strategies to improve in-hospital and discharge medical therapy are needed to improve local process-of-care measures and ACS outcomes in Kerala.
PMID: 23800985 [PubMed - as supplied by publisher]