A description of the characteristics of patients with non-ST elevation acute coronary syndromes admitted to different settings in the 1990s

Jones, I; Flather, M; Johnson, M; Barrow, S; Thompson, D

Abstract

Background: Little is known about the characteristics of patients who were admitted
to the coronary care unit (CCU) in the 1990s with non-ST elevation acute coronary
syndromes (ACS) compared with those admitted to medical and cardiology wards in
hospitals in the United Kingdom (UK).
Aim: To understand if there were systematic differences in the characteristics of
patients who were admitted to UK critical care units (CCU), intermediate care
environments (cardiology wards) or generalist wards (acute medical ward) in an
observational study carried out in the 1990s.
Methods: This paper is based on a secondary analysis of PRAIS (UK), a prospective,
observational, multi-centred study which recruited 1038 patients with non-ST
elevation ACS. This analysis compares the characteristics of 860 of these patients
dependent on whether they were cared for in a coronary care unit, acute medical
ward or cardiology ward.
Results: The results showed that patients admitted to CCU were more likely to
be younger, male, have a history of diabetes or have ST depression on their ECG.
There was very little difference in other risk factors or prior concomitant therapy.
Interestingly there were no systematic differences in treatments or outcomes other than would be expected by chance, although there were trends to higher rates of MI
and heart failure in the CCU group.
Conclusion: Our analysis shows that the main drivers of admission to CCU in the 1990s
were ST depression and MI—–both indicators of high risk, but older age and female
gender seemed to decrease the likelihood of admission to CCU. Criteria for admission
to specific specialist and non-specialist care environments should be standardised and
the use of risk scores could be an important way forward.

Citation

Jones, I., Flather, M., Johnson, M., Barrow, S., & Thompson, D. (2008). A description of the characteristics of patients with non-ST elevation acute coronary syndromes admitted to different settings in the 1990s. Intensive and Critical Care Nursing, 24(5), 286-294. https://doi.org/10.1016/j.iccn.2008.01.005

• Journal Article Type: Article
• Publication Date: Jan 1, 2008
• Deposit Date: May 4, 2011
• Journal: Intensive and Critical Care Nursing
• Print ISSN: 0964-3397
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 24
• Issue: 5
• Pages: 286-294
• DOI: https://doi.org/10.1016/j.iccn.2008.01.005
• Publisher URL: http://dx.doi.org/10.1016/j.iccn.2008.01.005