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Swan-Ganz catheter use and mortality of myocardial infarction patients

M S Blumberg1, G S Binns

  • 1Kaiser Foundation Health Plan, Inc., Oakland, CA 94612.

Health Care Financing Review
|February 2, 1995
PubMed

Insights

Higher use of Swan-Ganz catheters (SGC) in acute myocardial infarction (AMI) patients was linked to increased mortality. This association between SGC use and mortality in AMI cases was observed across hospitals, regardless of patient volume.

Area of Science:

  • Cardiology
  • Health Services Research
  • Medical Informatics

Background:

  • Acute myocardial infarction (AMI) is a leading cause of mortality.
  • The use of Swan-Ganz catheters (SGC) in AMI patients varies significantly across healthcare facilities.
  • Understanding the relationship between SGC utilization and patient outcomes is crucial for improving care.

Purpose of the Study:

  • To investigate the association between Swan-Ganz catheter (SGC) use and 30-day mortality in Medicare patients with acute myocardial infarction (AMI).
  • To examine if this association differs based on hospital SGC procedure ratio (SPR) and annual AMI case volume.

Main Methods:

  • Utilized the 1989 Medicare Provider Analysis and Review (MEDPAR) file.
  • Calculated 30-day indirectly standardized mortality ratios (SMR) for acute myocardial infarction (AMI) cases at 2,900 hospitals.
  • Calculated indirectly standardized Swan-Ganz catheter (SGC) procedure ratios (SPR) for AMI cases at each hospital.

Main Results:

  • Hospitals with higher SGC procedure ratios (SPR) demonstrated higher SMRs for AMI patients.
  • This positive association between SGC use and mortality persisted even after stratifying hospitals by their annual volume of AMI cases.

Conclusions:

  • Higher Swan-Ganz catheter (SGC) utilization in acute myocardial infarction (AMI) care is associated with increased patient mortality.
  • This finding suggests a potential need to re-evaluate SGC use protocols in AMI management.
  • The study design, using cases stratified by hospital SPR, helps mitigate case selection bias in observational research.

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