Large Michigan Hospitals Show a Wide Variation in ICU stays for AMI Patients Discharged Alive
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By: James Pitt  May. 23, 2018

Acute myocardial infarction (AMI) - also known as heart attack - is a major cause of mortality. Several antiplatelet drugs are commonly used for patients at risk of AMI. A randomized trial of 13,408 patients published in the Lancet finds acute coronary syndrome patients on ticagrelor had lower mortality than patients on clopidogrel. An observational study in France of 54,097 patients found that patients on ticagrelor had lower mortality and were less likely to have ICU stays than patients on clopidogrel.

To examine the potential gains from better treatment in Michigan, Dexur analysts examined ICU stays in AMI patients at Michigan hospitals with over 5,000 patients per year, using 2013-2016 CMS discharge data.

Percentage of DRG 280 Patients with ICU Stays (2013-2016) Detroit Area

Hospitals vary widely in their ICU admission practices. Many hospitals report fewer than 11 ICU stays for DRGs 291 and 292. On the other hand, there is a cluster of hospitals that admit nearly all surviving AMI patients to the ICU regardless of DRG. This cluster consists of Beaumont Hospital-Troy, Beaumont Hospital - Royal Oak, Midmichigan Medical Center-Midland, and Henry Ford Wyandotte Hospital.

The percentage of patients who survived AMI without experiencing complications (DRG 281) or major complications (DRG 280) also varied widely across hospitals.

Spectrum Health Butterworth Hospital had a particularly high rate of AMI survivors without complications (DRG 282), at 25%. The highest rate of complications among survivors was at Genesys Regional Medical Center, where only 6% of survivors did not have complications or major complications.

DEXUR PRO MEMBERS GET ACCESS TO:

  1. Total discharges for DRG 280
  2. Percent of discharges with ICU stay for DRG 280
  3. Total discharges for DRG 281
  4. Percent of discharges with ICU stay for DRG 281
  5. Total discharges for DRG 282
  6. Percent of discharges with ICU stay for DRG 282
  7. Total discharges for DRG 283
  8. Percent of discharges with ICU stay for DRG 283
  9. Total discharges for DRG 284
  10. Total number of AMI discharges where patient survived
  11. Percent of survived AMIs where patient had no complications

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ABOUT THE AUTHOR

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James Pitt

James Pitt is a science writer with experience in medical devices and textbook publishing. His hobbies include reading, flintknapping, and squinting at RStudio. He received a bachelor's in Human Evolutionary Biology from Harvard.