Key factors linked to lower death rates among patients with heart attacks

May 1, 2012, Yale University

(Medical Xpress) -- Reviewing heart attack cases during monthly meetings with emergency medical services and maintaining a positive working environment are two of the relatively inexpensive strategies that can reduce mortality rates among patients with heart attacks, Yale researchers report in a study published in the May issue of Annals of Internal Medicine.

These strategies could potentially save thousands of lives each year, according to lead author Elizabeth H. Bradley, director of the Yale Global Health Leadership Institute. The study is the culmination of five years of research and results from an extensive web-based survey of more than 500 hospitals. This helped the Yale researchers identify some of the best strategies hospitals use to successfully treat .

They found that several factors were significantly associated with lower heart attack mortality rates, including: monthly meetings between hospital clinicians and to review cases; the constant presence of a cardiologist on site and if not possible, a pharmacist on the daily care team; an encouraging creative problem-solving by clinicians; and physician and nurses working together, rather than nurses alone.

Nonetheless, these strategies, were found to be used by less than 10% of the hospitals across the country that were involved in the survey.

“Although mortality rates as a result of heart attacks continue to decrease, substantial variation in these rates among hospitals across the United States persist, and we know little as to why some hospitals are more successful than others in treating patients with heart attacks,” Bradley said. “Our findings identify common features of hospitals with lower mortality rates and open the door for improvement nationally.”

The latest results support the team’s earlier work, which identified five areas that were prominent in higher-performing hospitals and less apparent in lower-performing hospitals.

Bradley said the findings further confirm that key aspects of the organizational environment of hospitals—including effective communication and collaboration among groups, broad staff presence and expertise, and a culture of problem-solving and learning—were apparent in the qualitative work and were statistically associated with higher in the quantitative work.

“These strategies we discovered to successfully treat patients with heart attacks were not expensive methods, and therefore, many of these tools and processes can be easily put into place by other hospitals to drastically improve the quality of care provided to these patients,” said senior author Dr. Harlan M. Krumholz, the Harold H. Hines, Jr. Professor of Medicine (Cardiology) at Yale School of Medicine.

The study was funded by the Agency for Healthcare Research and Quality, the Commonwealth Fund, and the United Fund. The work was also funded in part, by the Yale Clinical and Translational Science Award (CTSA) grant from the National Center for Research Resources at the National Institutes of Health.

Other authors on the study include Leslie Curry, Erica S. Spatz, Jeph Herrin, Emily J. Cherlin, Jeptha Curtis, Jennifer W. Thompson, Henry H. Ting, and Yongfei Wang.

Explore further: Most hospitals miss critical window for heart attack transfer patients

More information: Annals of Internal Medicine, Vol. 156, No. 9 (May 1, 2012)

Related Stories

Most hospitals miss critical window for heart attack transfer patients

November 28, 2011
Most heart attack patients transferred between hospitals for the emergency artery-opening procedure called angioplasty are not transported as quickly as they should be, Yale School of medicine researchers report in the first ...

Death rate measure used to judge hospital quality may be misleading

January 3, 2012
Hospitals, health insurers and patients often rely on patient death rates in hospitals to compare hospital quality. Now a new study by researchers at Yale School of Medicine questions the accuracy of that widely used approach ...

Death rate from heart attack higher in US territories than on mainland

June 27, 2011
There is a 17% greater risk of dying after a heart attack if you are treated in a hospital located in a U.S. territory -- i.e. the U.S. Virgin Islands, Guam, Puerto Rico, American Samoa, and Northern Mariana Islands -- rather ...

Deaths plague even top hospitals

August 8, 2011
More than 120 hospitals given top marks by patients for providing excellent care also have a darker distinction: high death rates for heart attack, heart failure or pneumonia, a USA Today analysis of new Medicare data ...

Recommended for you

New cellular pathway helps explain how inflammation leads to artery disease

June 21, 2018
Investigators have identified a new cellular pathway that may help explain how arterial inflammation develops into atherosclerosis—deposits of cholesterol, fats and other substances that create plaque, clog arteries and ...

'Smart stent' detects narrowing of arteries

June 19, 2018
For every three individuals who have had a stent implanted to keep clogged arteries open and prevent a heart attack, at least one will experience restenosis—the renewed narrowing of the artery due to plaque buildup or scarring—which ...

Marriage may protect against heart disease / stroke and associated risk of death

June 18, 2018
Marriage may protect against the development of heart disease/stroke as well as influencing who is more likely to die of it, suggests a pooled analysis of the available data, published online in the journal Heart.

Deaths from cardiac arrest are misclassified, overestimated

June 18, 2018
Forty percent of deaths attributed to cardiac arrest are not sudden or unexpected, and nearly half of the remainder are not arrhythmic—the only situation in which CPR and defibrillators are effective—according to an analysis ...

Tick-borne meat sensitivity linked to heart disease

June 15, 2018
University of Virginia School of Medicine researchers have linked sensitivity to an allergen in red meat—a sensitivity spread by tick bites—with a buildup of fatty plaque in the arteries of the heart. This buildup may ...

The molecules that energize babies' hearts

June 14, 2018
A metabolic process that provides heart muscle with energy fails to mature in newborns with thickened heart walls, according to a Japan–Canada research team.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.