JEOFFREY K. STROSS, M.D.; PARK W. WILLIS III, M.D., F.A.C.P.; E. W. REYNOLDS Jr., M.D.; RALPH E. LEWIS, M.P.H.; IRWIN J. SCHATZ, M.D., F.A.C.P.; LUANNE C. BELLFY, R.N.; JEANNE COPP, M.P.H.
A prospective study was undertaken from 1969 to 1974 to evaluate a program establishing coronary care units in small community hospitals. Crude mortality rates from acute myocardial infarction in these small hospitals were 14.5%, slightly higher but not statistically different from concurrently collected data in three larger comparison hospitals (11.5%). Multivariate discriminate analysis of clinical characteristics was used to calculate a risk score for each patient admitted. Observed deaths exceeded expected deaths (134 versus 119) (P > 0.30) in small hospitals but observed deaths were less than expected (55 versus 77) (P < 0.05) in comparison hospitals. Mortality was significantly greater in those units admitting fewer than 60 patients with infarctions yearly (20.9%) than in those admitting more than 60 (10.7%) (P < 0.001). These data suggest that coronary care units in small community hospitals can provide adequate coronary care, but their level of performance drops when fewer than 60 patients with infarctions are admitted yearly.
STROSS JK, WILLIS PW, REYNOLDS EW, LEWIS RE, SCHATZ IJ, BELLFY LC, et al. Effectiveness of Coronary Care Units in Small Community Hospitals. Ann Intern Med. ;85:709–713. doi: 10.7326/0003-4819-85-6-709
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Published: Ann Intern Med. 1976;85(6):709-713.
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