Community hospital experience with recombinant tissue plasminogen activator in acute myocardial infarction.
Clinical features, outcomes, and hospital charges of 51 consecutive patients who had had acute myocardial infarction (MI) and who had received intravenous tissue plasminogen activator (TPA) at a community teaching hospital were reviewed retrospectively. The overall mortality rate was 22%, including four patients (8%) who had died of hemorrhagic complications, three of whom (6%) had had intracerebral hemorrhages. Despite similar mean ages and lengths of hospital stay, TPA patients had had significantly higher total hospital charges and ancillary charges than had had concurrent MI patients who had not received TPA (p less than 0.0001). In a community hospital setting, older patients may be at higher risk for intracranial hemorrhage when treated with TPA, especially in the presence of other risk factors.
Austin
S M
SM
Department of Internal Medicine, St. Elizabeth Hospital Medical Center, Youngstown, OH 44501-1790.
Caro
M
M
Gemmel
D
D
D000368:Aged; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D009820:Ohio; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator