Navigation Links
Hospitals Vary Widely in Rate of Heart Procedures: Study
Date:8/8/2011

By Amanda Gardner
HealthDay Reporter

MONDAY, Aug. 8 (HealthDay News) -- At some U.S. hospitals, nearly everyone who has cardiac catheterization to diagnose heart disease is found to have major blockages requiring some kind of action.

But in other hospitals, relatively few are found to have a major blockage when undergoing this procedure, indicating that many patients may be getting unnecessary procedures, according to a study in the Aug. 16 issue of the Journal of the American College of Cardiology.

"We're not doing as well as we thought. We need to improve," said study author Dr. Pamela S. Douglas, the Ursula Geller professor of cardiovascular research at Duke Clinical Research Institute in Durham, N.C. "You don't want to do this in people who don't need it."

Cardiac catheterization is when a doctor threads a small tube called a catheter into the heart from the groin or the arm. Through images obtained from angiography, the doctor can see blockages that might signal problems ahead.

This study is a follow-up to a 2010 paper by the same group of researchers that found that "the rate at which obstructive coronary artery disease was found nationally was much lower than everybody expected," Douglas said.

The new study may be the first to look at how hospitals differ.

This time, Douglas and her colleagues reviewed data on almost 600,000 patients with no known heart disease who had elected to undergo coronary angiography from 2005 to 2008 at one of almost 700 hospitals nationwide.

Obstructive coronary artery disease (CAD) was defined as a 50 percent or higher blockage of a major vessel.

While some hospitals found major blockages in all patients undergoing the procedure, others only found blockages in 23 percent of patients. The rates stayed consistent at institutions over the three years.

It also seemed clear, though, why hospitals varied so much.

Those that found lower rates of obstructive CAD tended to perform the procedure on lower-risk patients, including those who were younger and had no or atypical symptoms.

Hospitals at the other end of the scale seemed to select their patients more carefully, only performing the procedure on higher-risk patients, such as those with hypertension or diabetes. They also were less likely to prescribe aspirin, beta blockers, blood thinners and statins, and more likely to be low-volume centers, meaning they perform fewer of these procedures.

"When we looked at the average rate of finding obstructive coronary artery disease, we found that all hospitals are not the same," Douglas said. "There is substantial variation."

"That would represent a pattern of care in that particular institution compared to another institution," she added. "It's not just a patient-by-patient decision but decisions determined by the practice or culture in a particular hospital, whether hospitals are more or less aggressive."

Douglas suggests that the guidelines for making decisions on who undergoes this procedure should be tightened.

"There's a need for consensus agreement amongst cardiologists, and some standards as to which kinds of patients should undergo catheterization and which shouldn't," she said.

The American College of Cardiology will issue such criteria later this year, she added.

Dr. John Gassler, a professor of medicine at the University of Rochester Medical Center in New York, finds the study "intriguing" but doesn't feel it answers the question of overuse of diagnostic catheterization.

"There are many factors involved in making this decision," he said.

More information

The U.S. National Library of Medicine has more on cardiac catheterization.

SOURCES: Pamela S. Douglas, M.D., Ursula Geller professor of cardiovascular research, Duke Clinical Research Institute, Durham, N.C.; John Gassler, M.D., associate professor, medicine, University of Rochester Medical Center, New York; Aug. 16, 2011, Journal of the American College of Cardiology


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. The private sale of drugs in public hospitals
2. Most pandemic plans in Ontario hospitals have not been tested: Queens University study
3. SHARECOR Partners With Quantros, Inc. to Facilitate Core Measures and Regulatory Reporting in Louisiana Hospitals
4. Kaiser Foundation Health Plan and Hospitals Report Fourth Quarter and Fiscal Year 2009 Financial Results
5. Father Channels His Grief into Advocacy, Promotes Simple Actions to Make Hospitals Safer for Children
6. Vestara and EXP Pharmaceutical Services Corp. Announce Partnership Making Available Industry's Only Automated Pharmaceutical Waste Management Solution to over 5,000 U.S. Hospitals
7. Small to Mid-Sized Hospitals Turn to Orion Health to Implement Health IT Solutions for Improved Patient Care and Outcomes
8. Patients Do Better at Hospitals That Follow Stroke Guidelines
9. Evidence-based care and outcomes improve at Get With The Guidelines-Stroke hospitals
10. Global Hospitals and Healthcare Suppliers Focus on Cutting Costs and Improving Quality at 2010 GHX Supply Chain Summit
11. COBRAGuard Partners With THA to Offer Texas Hospitals COBRA Relief
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Hospitals Vary Widely in Rate of Heart Procedures: Study 
(Date:6/26/2016)... Michigan (PRWEB) , ... June 26, 2016 , ... ... to fertility once they have been diagnosed with endometriosis. These women need a ... they also require a comprehensive approach that can help for preservation of fertility ...
(Date:6/25/2016)... Aliso Viejo, California (PRWEB) , ... June 25, 2016 , ... ... preset to fit their specific project," said Christina Austin - CEO of Pixel Film ... all fully customizable and all within Final Cut Pro X . Simply select ...
(Date:6/25/2016)... ... ... Friday, June 10, Van Mitchell, Secretary of the Maryland Department of Health and Mental ... exemplary accomplishments in worksite health promotion. , The Wellness at Work Awards took place ... BWI Marriott in Linthicum Heights. iHire was one of 42 businesses to receive an ...
(Date:6/24/2016)... ... ... June 19, 2016 is World Sickle Cell Observance Day. In an effort to ... treatments, Serenity Recovery Center of Marne, Michigan, has issued a pain management ... (SCD) is a disorder of the red blood cells, which can cause episodes of ...
(Date:6/24/2016)... ... June 24, 2016 , ... Dr. Amanda ... orthodontic treatment. Dr. Cheng has extensive experience with all areas of orthodontics, including ... accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to orthodontic treatment. ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... -- Jazz Pharmaceuticals plc (Nasdaq: JAZZ ) ... Improvements Act of 1976, as amended ("HSR"), with respect ... Nasdaq: CPXX ) expired effective June 24, ... As previously announced on May 31, 2016, Jazz Pharmaceuticals ... which Jazz Pharmaceuticals has commenced a tender offer for ...
(Date:6/24/2016)... , June 24, 2016  Consumers have ... and regulators/payers have placed more emphasis on patient ... patient support programs in the pharmaceutical industry have ... medications. Consequently, pharmaceutical companies are focusing on becoming ... are providing products and services that improve health. ...
(Date:6/24/2016)... 2016   Bay Area Lyme Foundation , ... Center for Tick Borne Illness , Harvard Medical ... Hacking Medicine, University of California, Berkeley, and the ... five finalists of Lyme Innovation , the ... 100 scientists, clinicians, researchers, entrepreneurs, and investors from ...
Breaking Medicine Technology: