PMID- 23851248
OWN - NLM
STAT- MEDLINE
DCOM- 20160422
LR  - 20181202
IS  - 1120-9763 (Print)
IS  - 1120-9763 (Linking)
VI  - 37
IP  - 2-3
DP  - 2013 Mar-Jun
TI  - [Mortality aftermyocardial infarction: when the health local organization network 
      has a role in interpreting themarkers of theNational Agency for RegionalHealth 
      Services].
PG  - 176-9
AB  - The Italian National Outcome Programme has assessed the performance of Italian 
      hospitals regarding several clinical performance indicators, including 
      30-daymortality after admission for acute myocardial infarction. Risk adjustment 
      was obtained using demographic and comorbidity data based on the hospital 
      discharge databases in the index admission, as well as in those of the previous 
      two years. Noticeably, the ICD-9-CM 410.7* classification coding for NSTEMI 
      (Non-ST elevation myocardial infarction)myocardial infarction, i.e. the less 
      severe form, was not used, due to known variability in its use. We found that 
      hospital-specific adjusted relative risk of death versus the national mean, as 
      computed by the programme, is negatively associated with the proportion of NSTEMI 
      infarctions at each Tuscan and Florentine hospital, coherently with the 
      hypothesis of a selection by the emergency network, which addresses STEMI (ST 
      elevation myocardial infarction) patients to hospitals offering haemodynamic 
      laboratory with reperfusive services. Individual level clinical data of 3,200 
      patients in the AMI-Florence study in the period April 2008-March 2010 found that 
      ICD-9-CM410.7* is underused. The analysis based on hospital discharge diagnoses 
      (410.7* vs. other 410* codes) cannot explain differences in mortality among 
      Florentine hospitals, as opposed to the use of a classification of myocardial 
      infarction type (STEMI vs. NSTEMI) based on clinical data collected in 
      AMI-Florence.
FAU - Virgili, Gianni
AU  - Virgili G
AD  - Direzione sanitaria, Azienda ospedaliero-universitaria Careggi, Firenze. 
      gianni.virgili@unifi.it
FAU - Barchielli, Alessandro
AU  - Barchielli A
FAU - Balzi, Daniela
AU  - Balzi D
FAU - Matarrese, Daniela
AU  - Matarrese D
FAU - Paci, Eugenio
AU  - Paci E
FAU - Gusinu, Roberto
AU  - Gusinu R
FAU - Zuppiroli, Alfredo
AU  - Zuppiroli A
FAU - Gensini, Gian Franco
AU  - Gensini GF
LA  - ita
PT  - Journal Article
TT  - Mortalita dopo infarto miocardico: quanto la rete locale di organizzazione 
      dell'assistenza conta nell'interpretazione di indicatori dell'Agenzia nazionale 
      per i servizi sanitari regionali.
PL  - Italy
TA  - Epidemiol Prev
JT  - Epidemiologia e prevenzione
JID - 8902507
SB  - IM
MH  - *Hospital Mortality
MH  - Humans
MH  - *Infarction
MH  - International Classification of Diseases
MH  - Italy
MH  - Myocardial Infarction
EDAT- 2013/07/16 06:00
MHDA- 2016/04/23 06:00
CRDT- 2013/07/16 06:00
PHST- 2013/07/16 06:00 [entrez]
PHST- 2013/07/16 06:00 [pubmed]
PHST- 2016/04/23 06:00 [medline]
AID - 1777 [pii]
PST - ppublish
SO  - Epidemiol Prev. 2013 Mar-Jun;37(2-3):176-9.