title: Mortality in the coronary care unit.
abstract: OBJECTIVE
  Currently, there are limited data on mortality or predictors of survival for patients admitted to the coronary care unit (CCU). The purpose of this study was to provide data on mortality in the modern-day CCU and to better define factors influencing patient survival.
  
  
  METHODS
  A survey was conducted of all patients admitted to CCUs in New York City metropolitan academic hospitals in 2011, followed by a retrospective analysis comparing clinical data from 59 nonsurvivors with those from 897 survivors at two representative institutions.
  
  
  RESULTS
  The weighted average mortality in the CCU across all hospitals was 5.6% (range 2.2-9.2%). The average age of the patients admitted to the CCU was 67 years, with 68% being male. Acute coronary syndromes accounted for 57% of all CCU admissions. Survival was worse in patients admitted for cardiac arrest (P=0.000), sepsis (P=0.002), primary respiratory failure (P=0.031), and systolic heart failure (P=0.003). Excluding patients who were made 'do not resuscitate' during their CCU stay, patients receiving treatments such as defibrillation after in-CCU cardiac arrest, right heart invasive monitoring, mechanical ventilation, inotropic support, emergent dialysis, or placement of an intra-aortic balloon pump had higher rates of in-CCU mortality. The most frequent causes of death were intractable cardiogenic shock, brain death, respiratory failure, multiorgan failure, or hypotension.
  
  
  CONCLUSIONS
  This study provides additional mortality information for the modern-day CCU and should help identify factors that may predict survival.
authors.affiliation: aBeth Israel Medical Center, Thomas Killip Division of Cardiology, Albert Einstein College of Medicine bDivision of Cardiology, New York Hospital Queens, New York, USA.
authors.forename: Justin A
authors.initials: JA
authors.lastname: Ratcliffe
authors.forename: Eelin
authors.initials: E
authors.lastname: Wilson
authors.forename: Sirajul
authors.initials: S
authors.lastname: Islam
authors.forename: Zlata
authors.initials: Z
authors.lastname: Platsman
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Leou
authors.forename: Gwendolyn
authors.initials: G
authors.lastname: Williams
authors.forename: David
authors.initials: D
authors.lastname: Lucido
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Moustakakis
authors.forename: Maurice
authors.initials: M
authors.lastname: Rachko
authors.forename: Steven R
authors.initials: SR
authors.lastname: Bergmann
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D002423:Cause of Death; D015897:Comorbidity; D003325:Coronary Care Units; D005260:Female; D019538:Health Care Surveys; D006331:Heart Diseases / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009519:New York City / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors