Development of a cardiologist delivered service leads to improved outcomes following admission with acute coronary syndromes in a large district general hospital

• Published in: Acute cardiac care Vol. 14; no. 1; p. 1
• Main Authors: Ng Kam Chuen, M J, Schofield, R, Sankaranarayanan, R, Crowe, C, Helm, K, Lane, D, Singh, R K, Mcdonald, J, Balachandran, K P
• Format: Journal Article
• Language: English
• Published: England 01.03.2012
• Subjects: Acute Coronary Syndrome - mortality; Acute Coronary Syndrome - therapy; Aged; Aged, 80 and over; Cardiology Service, Hospital; Female; Hospital Mortality; Hospitalization - statistics & numerical data; Hospitals, District; Hospitals, General; Humans; Length of Stay - statistics & numerical data; Male; Middle Aged; Outcome Assessment (Health Care); Proportional Hazards Models; Retrospective Studies; State Medicine; United Kingdom
• ISSN: 1748-295X
• DOI: 10.3109/17482941.2012.655290

East Lancashire Hospitals NHS Trust reorganized its services in October 2007 with acute admissions sent to one site which allowed the development of a 24/7 Consultant delivered cardiology service. A retrospective analysis of all patients admitted with an acute coronary syndrome between two periods: Group 1: October 2006 to September 2007 and Group 2: October 2007 and September 2008. We looked at the following end points-length of stay, in-hospital and 30 day all cause mortality. 633 patients in group 1 and 748 patients in group 2. There was significant reduction in length of stay from a median (IQ range) 7 (5-11) days to 5 (3-9) days; P<0.0001. The in-hospital mortality reduced from 15.8% (n=100) to 7.6% (n=56); P<0.0001. The mortality at 30 days reduced from 15.2% (n=96) to 8.3% (n=62); P<0.0001. These reductions remained significant after adjustment for demographic and risk factor variables. A 24/7 Consultant Cardiologist delivered cardiac care is associated with marked reductions in all cause mortality following admission with acute coronary syndromes. This improvement occurred with a significant reduction in hospital length of stay.