A description of the characteristics of patients with non-ST elevation acute coronary syndromes admitted to different setting in the 1990s

Jones, Ian, Flather, Marcus, Johnson, Martin, Barrow, Steve and Thompson, D. (2008) A description of the characteristics of patients with non-ST elevation acute coronary syndromes admitted to different setting in the 1990s. Intensive and Critical Care Nursing, 24 5: 286-294.


Author Jones, Ian
Flather, Marcus
Johnson, Martin
Barrow, Steve
Thompson, D.
Title A description of the characteristics of patients with non-ST elevation acute coronary syndromes admitted to different setting in the 1990s
Journal name Intensive and Critical Care Nursing   Check publisher's open access policy
ISSN 0964-3397
1532-4036
Publication date 2008-10
Sub-type Article (original research)
DOI 10.1016/j.iccn.2008.01.005
Volume 24
Issue 5
Start page 286
End page 294
Total pages 9
Place of publication Edinburgh, U.K.
Publisher Churchill Livingstone
Collection year 2009
Language eng
Subject C1
920103 Cardiovascular System and Diseases
920210 Nursing
11 Medical and Health Sciences
110299 Cardiovascular Medicine and Haematology not elsewhere classified
111003 Clinical Nursing: Secondary (Acute Care)
1110 Nursing
Formatted abstract Background
Little is known about the characteristics of patients who were admitted to the coronary care unit (CCU) in the 1990s with non-ST elevation acute coronary syndromes (ACS) compared with those admitted to medical and cardiology wards in hospitals in the United Kingdom (UK).
Aim
To understand if there were systematic differences in the characteristics of patients who were admitted to UK critical care units (CCU), intermediate care environments (cardiology wards) or generalist wards (acute medical ward) in an observational study carried out in the 1990s.
Methods
This paper is based on a secondary analysis of PRAIS (UK), a prospective, observational, multi-centred study which recruited 1038 patients with non-ST elevation ACS. This analysis compares the characteristics of 860 of these patients dependent on whether they were cared for in a coronary care unit, acute medical ward or cardiology ward.
Results
The results showed that patients admitted to CCU were more likely to be younger, male, have a history of diabetes or have ST depression on their ECG. There was very little difference in other risk factors or prior concomitant therapy. Interestingly there were no systematic differences in treatments or outcomes other than would be expected by chance, although there were trends to higher rates of MI and heart failure in the CCU group.
Conclusion
Our analysis shows that the main drivers of admission to CCU in the 1990s were ST depression and MI—both indicators of high risk, but older age and female gender seemed to decrease the likelihood of admission to CCU. Criteria for admission to specific specialist and non-specialist care environments should be standardised and the use of risk scores could be an important way forward.
Keyword Coronary care unit
Acute cardiology ward
General medical ward
Non-ST elevation acute coronary syndromes
Q-Index Code C1
Q-Index Status Confirmed Code

 
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Created: Fri, 17 Apr 2009, 16:55:51 EST by Allison Peacock on behalf of Faculty Of Health Sciences