In-hospital HCRU with any statistically significant differences in use between patients with STEMI and NSTE-ACS with or without a history of CVD*
| Resource use item | STEMI | NSTE-ACS | Overall p value for STEMI vs NSTE-ACS | ||||||
|---|---|---|---|---|---|---|---|---|---|
| History of CVD (n=1042) | No history of CVD (n=3857) | All (n=4899) | p Value for CVD vs no CVD | History of CVD (n=2672) | No history of CVD (n=2904) | All (n=5576) | p Value for CVD vs no CVD | ||
| Laboratory tests and investigations | |||||||||
| On admission | |||||||||
| Blood glucose | 904 (86.8) | 3379 (87.6) | 4283 (87.4) | 0.46 | 2267 (84.8) | 2554 (87.9) | 4821 (86.5) | <0.001 | 0.14 |
| Haematocrit | 889 (85.3) | 3359 (87.1) | 4248 (86.7) | 0.14 | 2274 (85.1) | 2452 (84.4) | 4726 (84.8) | 0.49 | <0.01 |
| During hospitalisation | |||||||||
| Creatinine | 921 (88.4) | 3436 (89.1) | 4357 (88.9) | 0.53 | 2330 (87.2) | 2524 (86.9) | 4854 (87.1) | 0.75 | <0.01 |
| Diagnostic procedures | |||||||||
| Echocardiography | 852 (81.8) | 3250 (84.3) | 4102 (83.7) | 0.053 | 1957 (73.2) | 2238 (77.1) | 4195 (75.2) | <0.001 | <0.0001 |
| Non-invasive testing | |||||||||
| Treadmill | 29 (2.8) | 184 (4.8) | 213 (4.3) | <0.01 | 140 (5.2) | 198 (6.8) | 338 (6.1) | 0.02 | <0.0001 |
| Nuclear imaging | 36 (3.5) | 93 (2.4) | 129 (2.6) | 0.06 | 69 (2.6) | 38 (1.3) | 107 (1.9) | <0.001 | 0.01 |
| MRI | 11 (1.1) | 74 (1.9) | 85 (1.7) | 0.06 | 24 (0.9) | 33 (1.1) | 57 (1.0) | 0.38 | <0.01 |
| CT angiography | 10 (1.0) | 27 (0.7) | 37 (0.8) | 0.39 | 40 (1.5) | 32 (1.1) | 72 (1.3) | 0.19 | <0.01 |
| Therapeutic procedures | |||||||||
| Resuscitation | 40 (3.8) | 167 (4.3) | 207 (4.2) | 0.49 | 33 (1.2) | 40 (1.4) | 73 (1.3) | 0.64 | <0.0001 |
| Mechanical ventilation, n (%)† | 18 (1.7) | 92 (2.4) | 110 (2.2) | 0.20 | 28 (1.0) | 34 (1.2) | 62 (1.1) | 0.66 | <0.0001 |
| Duration of ventilation, days; mean (SD) | 2.1 (1.6) | 3.4 (3.2) | 3.2 (3.0) | 0.03 | 2.3 (3.0) | 2.8 (4.5) | 2.6 (3.9) | 0.63 | 0.30 |
| Median (range) | 1.5 (1–6) | 2 (1–16) | 2 (1–16) | … | 1 (1–12) | 1 (1–26) | 1 (1–26) | … | … |
| Intra-aortic balloon pumping | 18 (1.7) | 69 (1.8) | 87 (1.8) | 0.89 | 16 (0.6) | 20 (0.7) | 36 (0.6) | 0.68 | <0.0001 |
| Temporary pacemaker | 33 (3.2) | 97 (2.5) | 130 (2.7) | 0.25 | 22 (0.8) | 22 (0.8) | 44 (0.8) | 0.78 | <0.0001 |
| Permanent pacemaker | 9 (0.9) | 20 (0.5) | 29 (0.6) | 0.20 | 54 (2.0) | 12 (0.4) | 66 (1.2) | <0.0001 | <0.01 |
| Implantable cardiac defibrillator | 8 (0.8) | 17 (0.4) | 25 (0.5) | 0.19 | 24 (0.9) | 8 (0.3) | 32 (0.6) | <0.01 | 0.66 |
| Coronary intervention | |||||||||
| Any cardiac catheterisation | 878 (84.3) | 3338 (86.5) | 4216 (86.1) | 0.06 | 1952 (73.1) | 2404 (82.8) | 4356 (78.1) | <0.0001 | <0.0001 |
| Any PCI | 771 (74.0) | 3008 (78.0) | 3779 (77.1) | <0.01 | 1284 (48.1) | 1776 (61.2) | 3060 (54.9) | <0.0001 | <0.0001 |
| PCI + ≥1 stent (any) | 698 (67.0) | 2924 (75.8) | 3622 (73.9) | <0.0001 | 1182 (44.2) | 1728 (59.5) | 2910 (52.2) | <0.0001 | <0.0001 |
| PCI + ≥1 BMS | 456 (43.8) | 1871 (48.5) | 2327 (47.5) | <0.01 | 583 (21.8) | 900 (31.0) | 1483 (26.6) | <0.0001 | <0.0001 |
| PCI + ≥1 DES | 265 (25.4) | 1175 (30.5) | 1440 (29.4) | <0.01 | 667 (25.0) | 903 (31.1) | 1570 (28.2) | <0.0001 | 0.16 |
| CABG | 10 (1.0) | 48 (1.2) | 58 (1.2) | 0.45 | 93 (3.4) | 114 (3.9) | 207 (3.7) | 0.34 | <0.0001 |
| Antithrombotic medication‡ | |||||||||
| At least one fibrinolytic | 151 (14.5) | 610 (15.8) | 761 (15.5) | 0.30 | 7 (0.3) | 17 (0.6) | 24 (0.4) | 0.07 | <0.0001 |
| At least one antiplatelet agent | 1041 (99.9) | 3857 (100) | 4898 (100) | 0.05 | 2656 (99.4) | 2895 (99.7) | 5551 (99.6) | 0.11 | <0.0001 |
| Total LOS, days | |||||||||
| Mean (SD) | 8.3 (6.9) | 7.7 (6.0) | 7.8 (6.2) | <0.01 | 8.1 (5.8) | 7.2 (5.3) | 7.7 (5.6) | <0.0001 | 0.20 |
| Median (range) | 7 (1–97) | 6 (1–157) | 6 (1–157) | … | 6 (1–49) | 6 (1–62) | 6 (1–62) | … | … |
| Flow types (%)§ | |||||||||
| No transfer from hospital 1 | 690 (66.2) | 2338 (60.6) | 3028 (61.8) | <0.01 | 1937 (72.5) | 1888 (65.0) | 3825 (68.6) | <0.0001 | <0.0001 |
| Transfer from hospital 1 to 2 | 262 (25.1) | 1131 (29.3) | 1393 (28.4) | … | 382 (14.2) | 531 (18.3) | 913 (16.4) | … | … |
| Transfer from hospital 1 to 2 to 1 | 90 (8.6) | 388 (10.1) | 478 (9.8) | … | 353 (13.2) | 485 (16.7) | 838 (15.0) | … | … |
| LOS by transfer group, days | |||||||||
| No transfer from hospital 1 | |||||||||
| n (%) | 690 (66.2) | 2338¶ (60.6) | 3028 (61.8) | … | 1937 (72.5) | 1888 (65.0) | 3825 (68.6) | … | … |
| Mean LOS (SD) | 7.9 (4.9) | 7.4 (5.9) | 7.5 (5.7) | 0.02 | 7.4 (5.1) | 6.6 (4.6) | 7.0 (4.9) | <0.0001 | <0.001 |
| Median LOS (range) | 7 (1–41) | 6 (1–157) | 6 (1–157) | … | 6 (1–47) | 6 (1–62) | 6 (1–62) | … | … |
| Transfer from hospital 1 to 2 | |||||||||
| n (%) | 262 (25.1) | 1131 (29.3) | 1393 (28.4) | … | 382 (14.2) | 531 (18.3) | 913 (16.4) | … | … |
| Mean LOS (SD) | 9.5 (10.7) | 8.1 (5.7) | 8.4 (7.0) | 0.05 | 10.0 (7.0) | 8.1 (6.3) | 8.9 (6.7) | <0.0001 | 0.08 |
| Median LOS (range) | 7 (1–97) | 6 (1–76) | 7 (1–97) | … | 8 (3–49) | 7 (2–59) | 7 (2–59) | … | … |
| Transfer from hospital 1 to 2 to 1 | |||||||||
| n (%) | 90 (8.6) | 388 (10.1) | 478 (9.8) | … | 353 (13.2) | 485 (16.7) | 838 (15.0) | … | … |
| Mean LOS (SD) | 7.9 (5.0) | 8.2 (7.3) | 8.1 (6.9) | 0.74 | 10.1 (7.0) | 8.7 (5.9) | 9.3 (6.4) | <0.01 | <0.01 |
| Median LOS (range) | 6 (2–31) | 6.5 (1–95) | 6 (1–95) | … | 8 (1–46) | 7 (2–46) | 7 (1–46) | … | … |
Values are n (%) unless otherwise indicated.
*Includes resource use in all hospitals, if patients were transferred.
†Duration of mechanical ventilation data not available for 12 patients.
‡Data provided for in-hospital antithrombotic medication administered to ≥1% of patients with STEMI or NSTE-ACS.
§p Values for flow type compare the three flow types together.
¶LOS data not available for 1520 patients with STEMI and no prior CVD.
BMS, bare-metal stent; CABG, coronary artery bypass graft; CVD, cardiovascular disease; DES, drug-eluting stent; HCRU, healthcare resource use; LOS, length of hospital stay; NSTE-ACS, non-ST-segment elevation acute coronary syndrome; PCI, percutaneous coronary intervention; STEMI, ST-segment elevation myocardial infarction.