Management of acute myocardial infarction across five international academic centers showed varying length of stay (7.7 to 47.2 days) but similar one-year mortality (4% to 8%, P=0.881).
Cohort (n=694)
Yes
Does the management, resource utilization, and outcome of acute myocardial infarction vary among academic medical centers in different countries?
Despite significant international variations in resource utilization, invasive procedures, and length of stay for acute myocardial infarction, one-year mortality outcomes were similar across academic medical centers.
p-value: p=0.881
Background Although variability in management of cardiovascular syndromes has been demonstrated among regions, the extent to which variability exists among academic medical centers in different countries in uncertain. Methods This retrospective cohort study includes data on consecutive patients (n=694) with acute myocardial infarction who were admitted to five teaching hospitals from different countries (84, Brigham and Women's Hospital, USA; 97, Iizuka Hospital, Japan; 64, Hospital de Clinicas de Porto Alegre, Brazil; 62, Universitätsklinikum Charité, Germany; and 387, Hôpital Cantonal Universitaire de Genève, Switzerland) during a one-year period. Data were collected via chart review on clinical characteristics, rates of diagnostic and therapeutic interventions, complications and mortality, length of stay, and one-year follow-up outcomes. Results Patients' clinical characteristics varied among these institutions, with the lowest prevalence of antero-septal myocardial infarction at the US hospital. The US hospital had the lowest rate of use of thrombolytic therapy and did not have the highest rate for any invasive procedure. Average length of stay ranged from 7.7 ± 4.3 days in the US hospital to 47.2 ± 27.9 days in the Japanese hospital. There were no differences in one-year mortality among the four institutions (4% to 8%, P=0.881) for which data were available. Conclusions In this nonrandom sample of academic medical centers, the use of aggressive therapies for acute myocardial infarction was at least as common at non-US as US hospitals. Length of stay was much shorter at the US hospital. Despite these variations in management, evidence for differences in outcomes at one year were not detected.
Matsui et al. (Mon,) conducted a cohort in Acute myocardial infarction (n=694). Management at different international academic medical centers vs. Comparison among centers was evaluated on One-year mortality (p=0.881). Management of acute myocardial infarction across five international academic centers showed varying length of stay (7.7 to 47.2 days) but similar one-year mortality (4% to 8%, P=0.881).