Circ Cardiovasc Qual
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Circ Cardiovasc Qual · May 2013
Multicenter StudyContemporary use of prasugrel in clinical practice: insights from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium.
Prasugrel is a recently approved thienopyridine for use in patients with acute coronary syndromes undergoing percutaneous coronary intervention. There are no data on contemporary use of prasugrel in routine clinical practice. ⋯ There has been a steady increase in the use of prasugrel with the drug being used in ≈22% of patients undergoing percutaneous coronary intervention by study end. Prasugrel use in patients with known contraindications is not uncommon and may be a suitable target for focused quality improvement efforts.
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Circ Cardiovasc Qual · Jan 2013
Multicenter StudyProphylaxis against venous thromboembolism in hospitalized medically ill patients.
Many hospitalized medically ill patients are at risk of venous thromboembolism (VTE). Risk factors include prior VTE, older age, immobility, obesity, cardiac or respiratory failure, and cancer (at-risk patients). Although guidelines recommend use of VTE prophylaxis for at-risk patients, many may not receive it. ⋯ The majority of at-risk hospitalized medically ill patients do not receive VTE prophylaxis.
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Circ Cardiovasc Qual · Jan 2013
Multicenter StudySurvival trends in pediatric in-hospital cardiac arrests: an analysis from Get With the Guidelines-Resuscitation.
Despite ongoing efforts to improve the quality of pediatric resuscitation, it remains unknown whether survival in children with in-hospital cardiac arrest has improved. ⋯ Rates of survival to hospital discharge in children with in-hospital cardiac arrests have improved over the past decade without higher rates of neurological disability among survivors.
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Circ Cardiovasc Qual · Jan 2013
Multicenter Study Comparative StudyAchievement of guideline-concordant care and in-hospital outcomes in patients with coronary artery disease in teaching and nonteaching hospitals: results from the Get With The Guidelines-Coronary Artery Disease program.
Secondary prevention therapies improve longitudinal outcomes in patients with coronary artery disease. Previous studies showed that teaching hospitals (THs) more consistently use evidence-based secondary prevention therapies than non-THs (NTHs). It is unclear whether these differences persist after initiation of a national quality improvement system. ⋯ Adherence to guideline-recommended therapies increased over time with participation in the Get With The Guidelines-Coronary Artery Disease program, regardless of the teaching status. Guideline-concordant care over the full decade was higher in THs; however, NTHs demonstrated greater incremental improvement over time.
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Circ Cardiovasc Qual · Sep 2012
Multicenter Study Comparative StudyLeft ventricular ejection fraction assessment among patients with acute myocardial infarction and its association with hospital quality of care and evidence-based therapy use.
The left ventricular ejection fraction (LVEF) has prognostic and therapeutic utility after acute myocardial infarction (AMI). Although LVEF assessment is a key performance measure among AMI patients, contemporary rates of in-hospital assessment and its association with therapy use have not been well characterized. ⋯ The assessment of LVEF among patients with AMI has improved significantly over time, yet significant interhospital variability exists. Patients who did not have in-hospital LVEF assessment were less likely to receive evidence-based medications at discharge. These patients represent targets for future quality improvement efforts.