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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Use of Evidence-Based Therapy at Discharge for Patients with Acute Myocardial Infarction:Retrospective Audit of Medical Records
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Use of Evidence-Based Therapy at Discharge for Patients with Acute Myocardial Infarction:Retrospective Audit of Medical Records

机译：急性心肌梗死患者出院时采用循证疗法：病历回顾性审核

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Background: Various guidelines are available outlining optimal therapy for patients with acute myocardial infarction. Canadian institutions providing care for such patients have been encouraged to evaluate dieir care processes using specific indicators.Objective: To determine the proportion of patients with acute myocardial infarction discharged from a single health authority for whom acetylsalicylic acid (ASA), adrenergic beta-receptor antagonists (beta-blockers), angiotensin-converting enzyme (ACE) inhibitors, or 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) had been prescribed.Methods: Patients treated over a 12-month period (April 1, 2004, to March 31, 2005) for whom the most responsible diagnosis was acute myocardial infarction were eligible for inclusion in this review. Retrieved data included diagnosis, demographic information, comorbidities, and medications at the time of admission and discharge. Rates of discharge prescribing for the 4 drug classes were calculated for all patients and for "ideal" patients (those without documented contraindications). Rates were compared with published benchmark values.Results: Medical records for a total of 346 eligible patients were reviewed. Mean age was 65.3 years (standard deviation 13.4 years), and 226 (65.3%) of the patients were male. The coded diagnosis was ST-elevation myocardial infarction for 91 patients (26.3%), non-ST-elevation myocardial infarction for 164 (47.4%), and myocardial infarction not specified for 91 (26.3%). For "ideal" patients, the prescribing rates were 99.0% (308 of 311 patients) for ASA, 96.3% (310 of 322 patients) for beta-blockers, 90.4% (264 of 292 patients) for ACE inhibitors, and 88.8% (278 of 313 patients) for statins.Conclusions: Rates of prescribing of ASA, beta-blockers, ACE inhibitors, and statins for "ideal" patients discharged after treatment for acute myocardial infarction exceeded the published Canadian benchmark rates (> 90% for ASA, > 85% for beta-blockers and ACE inhibitors, > 70% for statins).
机译：背景：有各种指南概述了急性心肌梗死患者的最佳治疗方法。鼓励加拿大为此类患者提供医疗服务的机构使用特定指标评估死因护理过程。目的：确定从单个卫生机构出院并接受乙酰水杨酸（ASA），肾上腺素β受体拮抗剂的急性心肌梗死患者的比例（β-受体阻滞剂），血管紧张素转换酶（ACE）抑制剂或3-羟基-3-甲基戊二酰辅酶A（HMG-CoA）还原酶抑制剂（他汀类药物）已开具处方。方法：经过12个月治疗的患者（ 2004年4月1日至2005年3月31日），最负责任的诊断为急性心肌梗塞的患者可纳入本评价。检索的数据包括入院和出院时的诊断，人口统计学信息，合并症和用药情况。计算了所有患者和“理想”患者（未记录有禁忌症的患者）的4种药物处方的出院率。将比率与公布的基准值进行比较。结果：审查了总共346名合格患者的病历。平均年龄为65.3岁（标准差13.4岁），其中226例（65.3％）为男性。编码诊断为：ST段抬高型心肌梗死91例（26.3％），非ST段抬高型心肌梗死164例（47.4％）和未标明心肌梗塞的91例（26.3％）。对于“理想”患者，ASA的处方率分别为99.0％（311名患者中的308名），β-受体阻滞剂的处方率为96.3％（322名患者中的310名），ACEI抑制剂的处方率为90.4％（292名患者中的264名患者）和88.8％（他汀类药物的313名患者中有278名。结论：急性心肌梗死治疗后出院的“理想”患者的ASA，β受体阻滞剂，ACEI抑制剂和他汀类药物的开处方率超过了加拿大公布的基准率（ASA大于90％， β-受体阻滞剂和ACE抑制剂> 85％，他汀类药物> 70％。

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