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The Erne mobile intensive coronary care study mortality, survival and MICCU

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Show simple item record Donnelly, Michael MacKenzie, Gilbert 2021-07-08T08:00:09Z 2021
dc.description peer-reviewed en_US
dc.description.abstract This paper deals with the analysis and interpretation of data relating to mortality and survival in the first year of operation of the Erne MICCU study in Co. Fermanagh. Aims: We aimed to measure in-hospital mortality from AMI, on WHO criteria, identify factors influencing mortality and survival and assess the performance of the MICCU. Methods: All first admissions of suspected AMI to the CCU from the Fermanagh District in 1983-84. Some 297 patients were analysed. We recorded: demographic data, previous history of heart disease and co-morbidity, status of the current attack, delay to CCU, treatment and outcome. In total, 28 variables grouped as: (a) basic risk factors (18) and (b) clinical and treatment risk factors (10), were analysed. Outcomes: In-hospital mortality and survival and performance of the MICCU. Results: There were 329 admissions to the CCU of all types of which 297 (90.3%) were first admissions. Of the 297, 170 (57.2%) had AMI on WHO criteria and 42 (14.1%) were dead at discharge. Crude, 28 day, mortality (and unadjusted survival were statistically significantly worse in the AMI group. The multi-factor mortality analysis identified 5 variables influencing death at discharge. In relation to multi-factor survival, the MPR Weibull model identified a set of 9 variables in which the treatment variables pre-dominated over basic risk factors. The MICCU delivered patients to hospital statistically significantly earlier (5 hours on average) than other modes of transport, but did not prevent more deaths than the ordinary ambulance. Conclusions There was no evidence of a direct, statistically significant, beneficial MICCU effect in either of the multi-factor mortality or survival models. However, the performance of the MICCU, measured in terms of crude survival, resulted from an adverse case-mix, which, when controlled for, suggested a small MICCU benefit. The findings relate to the first year of operation of the Erne MICCU study and may improve in later years. en_US
dc.language.iso eng en_US
dc.publisher Springer en_US
dc.relation.ispartofseries Irish Journal of Medical Science; 191,pp. 175-185
dc.rights The original publication is available at en_US
dc.subject clinical epidemiology en_US
dc.subject CCU en_US
dc.subject MICCU en_US
dc.subject mortality en_US
dc.subject prospective study en_US
dc.subject survival en_US
dc.title The Erne mobile intensive coronary care study mortality, survival and MICCU en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.1007/s11845-020-02498-8
dc.contributor.sponsor Northern Ireland Chest Heart en_US
dc.contributor.sponsor Stroke Association and by the Western Health Trust en_US
dc.contributor.sponsor Western Health Trust 2022-02-17
dc.embargo.terms 2022-02-17 en_US
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US

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