22 August 2015

Heart Attack Deaths could be cut if Hospitals Stuck to Guidelines

Fewer heart attack patients die after treatment in Swedish hospitals than in UK ones, and that could be down to differences in how patients are treated, MRC research suggests.

The researchers looked at data on how hospitals in the UK and Sweden treated patients who had suffered the most severe form of heart attack (ST elevation heart attack), and how many of these patients survived for 30 days after their attack.

Overall, fewer heart attack patients died and there was a smaller variation in the death rate between hospitals in Sweden. Most hospitals in Sweden stuck to evidence-based national treatment guidelines by giving patients a stent to widen their coronary artery and then sending them home with beta blockers and other guideline-recommended medications.

In contrast, UK hospitals showed greater variation in how they treated patients: not all hospitals inserted stents and rate of use varied widely among those which did. More patients were treated with statins and anticoagulant drugs in UK hospitals than in Swedish hospitals.

MRC Population Health Sciences Fellow Dr Sheng-Chia Chung from the Farr Institute for Health Informatics Research, who led the research, explains: “Our study showed that the risk of dying is lower for patients admitted to hospitals with greater use of guideline-recommended treatments.

For example, in the UK, patients admitted to hospitals with highest stent use had a 32 per cent lower risk of dying, than in hospitals with the lowest stent use. Greater use of guideline-recommended treatment, and reduced variation in practice across UK hospitals may improve survival for heart attack patients.”

The original paper, ‘Comparison of hospital variation in acute myocardial infarction care and outcome between Sweden and United Kingdom: population based cohort study using nationwide clinical registries’ was published in The BMJ on 7 August 2015.