Coronary care unit utilization in Hamilton, Ontario, a city of 375,000 people.
All cardiac admissions to coronary care unit (CCU) beds and all intensive care unit (ICU) overflow admissions in Hamilton, Ontario, a city of 375,000 people, were documented over a one-year period, 1979-80. There were 4180 such admissions, 89% of them to CCUs. In the CCUs, 22% of patients had acute myocardial infarction, 24% unstable angina and 21% other chest pain. For myocardial infarction, hospitalization rate was 224 per 100,000, hospital mortality 42 per 100,000 and 48% of all myocardial infarction deaths in the community occurred in hospital. Of all myocardial infarction patients admitted to the CCU, 69% were correctly diagnosed on admission (sensitivity) and of all the admission diagnoses of myocardial infarction, 72% were eventually found to be correct (positive predictive value). Mean values for CCU patients overall were age 62.5 years, CCU stay 2.88 days and hospital stay 9.7 days; and for acute myocardial infarction patients in CCUs, age 63.4 years, CCU stay 3.98 days and hospital stay 13.28 days. For myocardial infarction, CCU mortality was 10.9%, hospital mortality 15.2% and, with the inclusion of ICU overflow patients, hospital mortality was 17.6%. Age-specific mortality for myocardial infarction was 9.7% age 45 to 64 years, and 32.8% over 70 years.
Cairns
J A
JA
Department of Medicine, McMaster University, Hamilton, Ontario.
Singer
J
J
Gent
M
M
Holder
D A
DA
Rogers
D
D
Sackett
D L
DL
Sealey
B
B
Tanser
P
P
Vandervoort
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000628:therapy; D003325:Coronary Care Units / Q000706:statistics & numerical data*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D009864:Ontario