Epidemiology and patterns of care of patients admitted to Italian Intensive Cardiac Care units: the BLITZ-3 registry.
BACKGROUND
Intensive cardiac care units (ICCUs) have shifted from the observation of patients with myocardial infarction to the care of different acute cardiac diseases. However, few data on such an evolution are available.


RESULTS
From 7 to 20 April 2008, 6986 consecutive patients admitted to 81% of Italian ICCUs were prospectively enrolled. Patients observed were mainly elderly men (median age 72 years) with several co-morbidities. Most of them were triaged to ICCU from the emergency room, but 15% of admissions were transfer-in from other hospitals. Several diagnostic and therapeutic procedures were applied (78% had echocardiography and 35% coronary angiography) during the ICCU stay [median length 4 days, interquartile range (IQR) 2-5]. The discharge diagnosis was ST-elevation acute coronary syndrome (ACS) in 21%, non-ST-elevation ACS in 31%, acute heart failure (AHF) in 14% and other acute non-ACS, non-AHF cardiac diseases in 34%. Of those with ST-elevation ACS, 60% received reperfusion (15% fibrinolysis and 45% primary percutaneous coronary intervention). The overall in-ICCU crude mortality was 3.3%.


CONCLUSIONS
The BLITZ-3 survey provides a unique snapshot of current epidemiology and patterns of care of patients admitted to ICCUs. Although ACS still remains the most frequent admission diagnosis, the number of non-ACS patients is substantial. However, the correct standard of care for these non-ACS patients has to be defined.
Casella
Gianni
G
Cardiology Department, Maggiore Hospital, Bologna, Italy.
Cassin
Matteo
M
Chiarella
Francesco
F
Chinaglia
Alessandra
A
Conte
Maria R
MR
Fradella
Giuseppe
G
Lucci
Donata
D
Maggioni
Aldo P
AP
Pirelli
Salvatore
S
Scorcu
Giampaolo
G
Visconti
Luigi Oltrona
LO
D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D003325:Coronary Care Units / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D014218:Triage / Q000706:statistics & numerical data