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Heart guidelines cut hospital deaths

DURHAM, N.C., April 25 (UPI) -- In-hospital deaths go down as adherence to cardiac treatment guidelines increases, said a study released Tuesday.

The American College of Cardiology and the American Heart Association have devised national guidelines for care of patients with non-ST-segment elevation heart attack and a condition marked by chest pains known as acute coronary syndrome.

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Researchers at Duke Medical Center who reviewed data from 350 academic and non-academic U.S. medical centers on 64,775 patients found that the treatment guidelines for patients with NSTE ACS "were followed in 74 percent of treatment opportunities."

But they also found adherence rates varied wildly among the hospitals. Facilities with the highest adherence levels had a median adherence score of 82 percent, compared to 63 percent for hospitals in the lowest group. And importantly, the researchers found a strong link between guideline adherence and a drop in death rates.

Specifically, death rates ranged from 6.31 percent in the lowest adherence group to 4.15 percent in the highest adherence group.

In fact, after adjusting for risk, the researchers found that a 10-percent increase in composite adherence to the ACC/AHA guidelines was associated with a 10-percent decrease in its patients' likelihood of in-hospital death.

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"Quality of care has been defined as 'the degree to which health service for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge,'" the study authors said.

"Our work supports the central hypothesis of hospital quality improvement; namely, better adherence with evidence-based care practices will result in better outcomes for patients who are treated," they said.

The study results appear in the April 26 issue of the Journal of the American Medical Association.

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