Differences in management and outcomes of acute myocardial infarction among four general hospitals in Japan.
OBJECTIVE
To ascertain the differences among hospitals in Japan in the management patterns and outcomes of patients with acute myocardial infarction (AMI).


METHODS
Retrospective cohort study by means of patient chart review.


METHODS
Four tertiary-care teaching hospitals in Japan observed over a 1-year period.


METHODS
Consecutive patients (N=482) admitted for AMI.


METHODS
Clinical characteristics, rates of diagnostic and therapeutic procedures performed, cardiac complications, and length of stay.


RESULTS
Patients' clinical characteristics differed significantly among the four hospitals in terms of age, gender, and prior cardiac history, but not in terms of comorbidity or infarct location. The frequency and type of diagnostic and therapeutic procedures were different, and in-hospital mortality varied (4-14%, P=0.022). Average length of hospital stay ranged from 15.8+/-12.6 days to 41.0+/-19.4 days (P=0.0001). After adjustment for the clinical characteristics, these differences remained significant among hospitals.


CONCLUSIONS
Considerable differences in the management and outcomes of patients with AMI exist in Japan.
Matsui
K
K
Department of General Medicine and Clinical Epidemiology, Kyoto University Hospital, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan.
Fukui
T
T
Hira
K
K
Sobashima
A
A
Okamatsu
S
S
Nobuyoshi
M
M
Hayashida
N
N
Tanaka
S
S
D000368:Aged; D005260:Female; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D012044:Regression Analysis; D012189:Retrospective Studies; D012306:Risk; D018709:Statistics, Nonparametric