A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction

J. M. Gore, R. J. Goldberg, D. H. Spodick, Joseph S Alpert, J. E. Dalen

Research output: Chapter in Book/Report/Conference proceedingChapter

256 Citations (Scopus)

Abstract

As part of an on-going population-based study of patients hospitalized with acute myocardial infarction (MI) in all 16 hospitals in the Worcester, Massachusetts Standard Metropolitan Statistical Area, temporal trends in the use of the pulmonary artery (PA) catheter were examined. Three thousand two hundred and sixty-three patients with validated acute MI during the calendar years 1975, 1978, 1981 and 1984 comprised the study population. There has been a consistent and significant increase in PA catheter use in patients with acute MI over time, from 7.2 percent in 1975, 13.8 percent in 1978, 14.8 percent in 1981 to 19.9 percent in 1984 (p < .001). Ninety-six percent of patients undergoing PA catheter investigation had either congestive heart failure (CHF), hypotension or cardiogenic shock. For the combined time periods, the in-hospital case fatality rate (CFR) for patients in CHF with a PA catheter was 44.8 percent compared to 25.3 percent for patients without a PA catheter (p < .001). For patients with hypotension and a PA catheter, in-hospital CFR was 48.3 percent compared to 32.2 percent for hypotensive patients not receiving a PA catheter (p < .001). In contrast, for patients in cardiogenic shock the in-hospital CFR was 74.4 percent for those receiving a PA catheter as compared to 79.1 percent for patients in shock not receiving a catheter. The use of a PA catheter was associated with an increased length of hospital stay irrespective of the development of acute clinical complications. Long-term prognosis for discharged hospital survivors who had a complicated MI, for up to a five-year follow-up period was similar whether the patient did or did not receive a PA catheter during the acute period of hospitalization. In conclusion, we could not demonstrate a beneficial effect associated with the use of the PA catheter on selected patient outcomes, including in-hospital and long-term prognosis and average hospital stay, in this community-wide study of patients hospitalized with acute MI.

Original languageEnglish (US)
Title of host publicationChest
Pages721-727
Number of pages7
Volume92
Edition4
StatePublished - 1987
Externally publishedYes

Fingerprint

Pulmonary Artery
Catheters
Myocardial Infarction
Length of Stay
Cardiogenic Shock
Hypotension
Mortality
Heart Failure
Population
Survivors
Shock
Hospitalization

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Gore, J. M., Goldberg, R. J., Spodick, D. H., Alpert, J. S., & Dalen, J. E. (1987). A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction. In Chest (4 ed., Vol. 92, pp. 721-727)

A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction. / Gore, J. M.; Goldberg, R. J.; Spodick, D. H.; Alpert, Joseph S; Dalen, J. E.

Chest. Vol. 92 4. ed. 1987. p. 721-727.

Research output: Chapter in Book/Report/Conference proceedingChapter

Gore, JM, Goldberg, RJ, Spodick, DH, Alpert, JS & Dalen, JE 1987, A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction. in Chest. 4 edn, vol. 92, pp. 721-727.
Gore JM, Goldberg RJ, Spodick DH, Alpert JS, Dalen JE. A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction. In Chest. 4 ed. Vol. 92. 1987. p. 721-727
Gore, J. M. ; Goldberg, R. J. ; Spodick, D. H. ; Alpert, Joseph S ; Dalen, J. E. / A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction. Chest. Vol. 92 4. ed. 1987. pp. 721-727
@inbook{dd1c6c20a25149e887adf5330590e1e0,
title = "A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction",
abstract = "As part of an on-going population-based study of patients hospitalized with acute myocardial infarction (MI) in all 16 hospitals in the Worcester, Massachusetts Standard Metropolitan Statistical Area, temporal trends in the use of the pulmonary artery (PA) catheter were examined. Three thousand two hundred and sixty-three patients with validated acute MI during the calendar years 1975, 1978, 1981 and 1984 comprised the study population. There has been a consistent and significant increase in PA catheter use in patients with acute MI over time, from 7.2 percent in 1975, 13.8 percent in 1978, 14.8 percent in 1981 to 19.9 percent in 1984 (p < .001). Ninety-six percent of patients undergoing PA catheter investigation had either congestive heart failure (CHF), hypotension or cardiogenic shock. For the combined time periods, the in-hospital case fatality rate (CFR) for patients in CHF with a PA catheter was 44.8 percent compared to 25.3 percent for patients without a PA catheter (p < .001). For patients with hypotension and a PA catheter, in-hospital CFR was 48.3 percent compared to 32.2 percent for hypotensive patients not receiving a PA catheter (p < .001). In contrast, for patients in cardiogenic shock the in-hospital CFR was 74.4 percent for those receiving a PA catheter as compared to 79.1 percent for patients in shock not receiving a catheter. The use of a PA catheter was associated with an increased length of hospital stay irrespective of the development of acute clinical complications. Long-term prognosis for discharged hospital survivors who had a complicated MI, for up to a five-year follow-up period was similar whether the patient did or did not receive a PA catheter during the acute period of hospitalization. In conclusion, we could not demonstrate a beneficial effect associated with the use of the PA catheter on selected patient outcomes, including in-hospital and long-term prognosis and average hospital stay, in this community-wide study of patients hospitalized with acute MI.",
author = "Gore, {J. M.} and Goldberg, {R. J.} and Spodick, {D. H.} and Alpert, {Joseph S} and Dalen, {J. E.}",
year = "1987",
language = "English (US)",
volume = "92",
pages = "721--727",
booktitle = "Chest",
edition = "4",

}

TY - CHAP

T1 - A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction

AU - Gore, J. M.

AU - Goldberg, R. J.

AU - Spodick, D. H.

AU - Alpert, Joseph S

AU - Dalen, J. E.

PY - 1987

Y1 - 1987

N2 - As part of an on-going population-based study of patients hospitalized with acute myocardial infarction (MI) in all 16 hospitals in the Worcester, Massachusetts Standard Metropolitan Statistical Area, temporal trends in the use of the pulmonary artery (PA) catheter were examined. Three thousand two hundred and sixty-three patients with validated acute MI during the calendar years 1975, 1978, 1981 and 1984 comprised the study population. There has been a consistent and significant increase in PA catheter use in patients with acute MI over time, from 7.2 percent in 1975, 13.8 percent in 1978, 14.8 percent in 1981 to 19.9 percent in 1984 (p < .001). Ninety-six percent of patients undergoing PA catheter investigation had either congestive heart failure (CHF), hypotension or cardiogenic shock. For the combined time periods, the in-hospital case fatality rate (CFR) for patients in CHF with a PA catheter was 44.8 percent compared to 25.3 percent for patients without a PA catheter (p < .001). For patients with hypotension and a PA catheter, in-hospital CFR was 48.3 percent compared to 32.2 percent for hypotensive patients not receiving a PA catheter (p < .001). In contrast, for patients in cardiogenic shock the in-hospital CFR was 74.4 percent for those receiving a PA catheter as compared to 79.1 percent for patients in shock not receiving a catheter. The use of a PA catheter was associated with an increased length of hospital stay irrespective of the development of acute clinical complications. Long-term prognosis for discharged hospital survivors who had a complicated MI, for up to a five-year follow-up period was similar whether the patient did or did not receive a PA catheter during the acute period of hospitalization. In conclusion, we could not demonstrate a beneficial effect associated with the use of the PA catheter on selected patient outcomes, including in-hospital and long-term prognosis and average hospital stay, in this community-wide study of patients hospitalized with acute MI.

AB - As part of an on-going population-based study of patients hospitalized with acute myocardial infarction (MI) in all 16 hospitals in the Worcester, Massachusetts Standard Metropolitan Statistical Area, temporal trends in the use of the pulmonary artery (PA) catheter were examined. Three thousand two hundred and sixty-three patients with validated acute MI during the calendar years 1975, 1978, 1981 and 1984 comprised the study population. There has been a consistent and significant increase in PA catheter use in patients with acute MI over time, from 7.2 percent in 1975, 13.8 percent in 1978, 14.8 percent in 1981 to 19.9 percent in 1984 (p < .001). Ninety-six percent of patients undergoing PA catheter investigation had either congestive heart failure (CHF), hypotension or cardiogenic shock. For the combined time periods, the in-hospital case fatality rate (CFR) for patients in CHF with a PA catheter was 44.8 percent compared to 25.3 percent for patients without a PA catheter (p < .001). For patients with hypotension and a PA catheter, in-hospital CFR was 48.3 percent compared to 32.2 percent for hypotensive patients not receiving a PA catheter (p < .001). In contrast, for patients in cardiogenic shock the in-hospital CFR was 74.4 percent for those receiving a PA catheter as compared to 79.1 percent for patients in shock not receiving a catheter. The use of a PA catheter was associated with an increased length of hospital stay irrespective of the development of acute clinical complications. Long-term prognosis for discharged hospital survivors who had a complicated MI, for up to a five-year follow-up period was similar whether the patient did or did not receive a PA catheter during the acute period of hospitalization. In conclusion, we could not demonstrate a beneficial effect associated with the use of the PA catheter on selected patient outcomes, including in-hospital and long-term prognosis and average hospital stay, in this community-wide study of patients hospitalized with acute MI.

UR - http://www.scopus.com/inward/record.url?scp=0023493373&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023493373&partnerID=8YFLogxK

M3 - Chapter

C2 - 3652758

AN - SCOPUS:0023493373

VL - 92

SP - 721

EP - 727

BT - Chest

ER -