Heart attack care is improving in England and Wales
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《英国医生杂志》
More patients than ever before in England and Wales who have had a heart attack are getting prompt thrombolytic treatment. This is one of the main findings in the fourth annual report of the myocardial infarction national audit project.
Between April 2004 and March 2005 in England 86% of eligible patients received thrombolytic treatment within the target time of 30 minutes of arriving at a hospital. This compares with 81% in 2003-4 and 44% during early 2001.
The report, which is compiled by the Royal College of Physicians?Clinical Effectiveness and Evaluation Unit, includes data from all hospitals in England and Wales that treat heart attack patients.
The improvement in care of heart attack patients has been more striking in Wales than in England, although overall fewer patients are receiving thrombolytic drugs there. In 2004-5 71% of eligible patients in Wales received thrombolytic treatment within 30 minutes of arriving at hospital, compared with 65% in 2003-04, when Welsh hospitals were first included in the report.
However, the aim to provide treatment within 60 minutes of a patient calling for help, which the college says is the most relevant overall indicator of care, has been more difficult to achieve. Only 47% of hospitals in England reached or exceeded the national target for 2004-05 of delivering thrombolytic treatment to 58% of patients within an hour of their call. In Wales just 29% patients were treated within an hour of calling for help.
Another finding of the report is that the number of ambulance staff who are able to diagnose heart attacks and treat patients with trombolytics before getting to hospital has increased. Overall 27 out of 31 ambulance services in England and Wales now give pre-hospital thrombolysis. More hospitals are now also using angioplasty to treat heart attack patients, although figures are not yet available.
The report shows that aftercare of heart attack patients is also improving, with 97% of patients in England being prescribed aspirin, 91% b blockers, and 95% statins. The figures for Wales were 96% for aspirin, 89% for b blockers, and 92% for statins.
Roger Boyle, the Department of Health抯 national director for heart disease, said: "When these data are shown to international audiences, they are staggered by the improvements that have been achieved not only in the timeliness of the treatment given in the first few minutes after the attack but also in the uptake of effective medication at the time of discharge, which even surpasses that seen in some clinical trials."
Jonathan Boyce, head of clinical audits at the Healthcare Commission, said: "This is good news for the health service. There has been real and significant progress on what is unquestionably a top national priority. However, as we get better at treating patients while they are in hospital, we must now also focus on their needs for rehabilitation and aftercare and advice on staying healthy."(BMJ Yasmina Dadi)
Between April 2004 and March 2005 in England 86% of eligible patients received thrombolytic treatment within the target time of 30 minutes of arriving at a hospital. This compares with 81% in 2003-4 and 44% during early 2001.
The report, which is compiled by the Royal College of Physicians?Clinical Effectiveness and Evaluation Unit, includes data from all hospitals in England and Wales that treat heart attack patients.
The improvement in care of heart attack patients has been more striking in Wales than in England, although overall fewer patients are receiving thrombolytic drugs there. In 2004-5 71% of eligible patients in Wales received thrombolytic treatment within 30 minutes of arriving at hospital, compared with 65% in 2003-04, when Welsh hospitals were first included in the report.
However, the aim to provide treatment within 60 minutes of a patient calling for help, which the college says is the most relevant overall indicator of care, has been more difficult to achieve. Only 47% of hospitals in England reached or exceeded the national target for 2004-05 of delivering thrombolytic treatment to 58% of patients within an hour of their call. In Wales just 29% patients were treated within an hour of calling for help.
Another finding of the report is that the number of ambulance staff who are able to diagnose heart attacks and treat patients with trombolytics before getting to hospital has increased. Overall 27 out of 31 ambulance services in England and Wales now give pre-hospital thrombolysis. More hospitals are now also using angioplasty to treat heart attack patients, although figures are not yet available.
The report shows that aftercare of heart attack patients is also improving, with 97% of patients in England being prescribed aspirin, 91% b blockers, and 95% statins. The figures for Wales were 96% for aspirin, 89% for b blockers, and 92% for statins.
Roger Boyle, the Department of Health抯 national director for heart disease, said: "When these data are shown to international audiences, they are staggered by the improvements that have been achieved not only in the timeliness of the treatment given in the first few minutes after the attack but also in the uptake of effective medication at the time of discharge, which even surpasses that seen in some clinical trials."
Jonathan Boyce, head of clinical audits at the Healthcare Commission, said: "This is good news for the health service. There has been real and significant progress on what is unquestionably a top national priority. However, as we get better at treating patients while they are in hospital, we must now also focus on their needs for rehabilitation and aftercare and advice on staying healthy."(BMJ Yasmina Dadi)