Development of a cardiologist delivered service leads to improved outcomes following admission with acute coronary syndromes in a large district general hospital

Acute Card Care. 2012 Mar;14(1):1-4. doi: 10.3109/17482941.2012.655290. Epub 2012 Jan 24.

Abstract

Background: East Lancashire Hospitals NHS Trust reorganized its services in October 2007 with acute admissions sent to one site which allowed the development of a 24/7 Consultant delivered cardiology service.

Methods: A retrospective analysis of all patients admitted with an acute coronary syndrome between two periods: Group 1: October 2006 to September 2007 and Group 2: October 2007 and September 2008. We looked at the following end points-length of stay, in-hospital and 30 day all cause mortality.

Results: 633 patients in group 1 and 748 patients in group 2. There was significant reduction in length of stay from a median (IQ range) 7 (5-11) days to 5 (3-9) days; P<0.0001. The in-hospital mortality reduced from 15.8% (n=100) to 7.6% (n=56); P<0.0001. The mortality at 30 days reduced from 15.2% (n=96) to 8.3% (n=62); P<0.0001. These reductions remained significant after adjustment for demographic and risk factor variables.

Conclusion: A 24/7 Consultant Cardiologist delivered cardiac care is associated with marked reductions in all cause mortality following admission with acute coronary syndromes. This improvement occurred with a significant reduction in hospital length of stay.

Publication types

  • Comparative Study

MeSH terms

  • Acute Coronary Syndrome / mortality
  • Acute Coronary Syndrome / therapy*
  • Aged
  • Aged, 80 and over
  • Cardiology Service, Hospital*
  • Female
  • Hospital Mortality*
  • Hospitalization / statistics & numerical data*
  • Hospitals, District
  • Hospitals, General
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Proportional Hazards Models
  • Retrospective Studies
  • State Medicine
  • United Kingdom