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A new performance indicator for acute myocardial infarction.

R M Norris1

  • 1Royal Sussex County Hospital, Cardiac Research Department, 1 Abbey Road, Brighton, East Sussex BN2 1ES, UK. robin.norris@talk21.com

Heart (British Cardiac Society)
|March 17, 2001
PubMed
Summary

A new performance indicator, lives saved per 1000 patients treated, effectively measures treatment success for acute myocardial infarction. This metric offers a reliable alternative to case fatality rates for auditing healthcare performance.

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Area of Science:

  • Cardiology
  • Healthcare Quality Improvement
  • Public Health

Background:

  • Acute myocardial infarction (AMI) management requires robust performance indicators to assess treatment efficacy.
  • Current outcome measures like case fatality may be influenced by diagnostic variations.
  • There is a need for a reliable, auditable outcome measure for AMI care.

Purpose of the Study:

  • To develop and evaluate a performance indicator for acute myocardial infarction (AMI).
  • To assess the feasibility of using 'lives saved per 1000 patients treated' as an alternative to case fatality.
  • To measure the performance of ambulance services and hospitals in managing AMI and cardiac arrest.

Main Methods:

  • A two-year audit of AMI and out-of-hospital cardiac arrest cases in patients under 75.

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  • Separate auditing of patient response times, ambulance service performance, and hospital resuscitation/thrombolytic treatments.
  • Comparison of hospital case fatality rates with the proposed 'lives saved/1000 patients treated' metric.

    • Main Results:

    • Overall, 83 lives were saved per 1000 patients treated (95% CI 70-96).
    • Out-of-hospital and in-hospital resuscitation accounted for 35% and 46% of lives saved, respectively.
    • Thrombolytic treatment was estimated to have saved 19% of lives; no significant differences in case fatality were observed between hospitals.

    Conclusions:

    • 'Lives saved per 1000 patients treated' is an easily measurable index for assessing healthcare performance.
    • This indicator effectively evaluates both ambulance services and hospital care quality.
    • Its robustness to diagnostic variations makes it a potentially superior alternative to case fatality for performance auditing.