PubMed · 9665209
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
D F Kong, E D Peterson. 1998. Squeezing the "value" from cost data.. https://doi.org/10.1016/s0002-8703(98)70172-3
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Widely available computer programs have been used to set up a database for patients with congenital heart disease in Malta. This database is used for clinical follow-up and research, and has been tailored to provide formatted output of specified results of follow-up as tables and graphs that are automatically updated with ongoing changes in the dataset. The system is easy to use, being menu- and icon driven and can be operated with minimal training. It has resulted in great saving of time not only in clinical practice, but also in the production of reports and analysis of data, as spreadsheets need only be created once and are then updated at will. The system also incorporates a patient summary generator and a on-screen picture library for patient explanation and teaching purposes.
Explore the source record for details and available documents.
It is known that acutely developed collaterals can prevent the onset of acute myocardial infarction (AMI) in the presence of a total coronary occlusion. However, there still is controversy concerning long-term follow-up of coronary collateral circulation to the infarct-related artery. In this study we analyze the prognostic role of collateral flow (degrees 0 to 3) as well as anterograde flow (degrees 0 to 3) in patients with AMI treated with thrombolytic therapy. Four hundred twenty-two patients (median age 57 years, 355 men) with AMI were treated with intravenous streptokinase and followed prospectively for up to 8 years. At the end of the study period, patients with collateral coronary flow 3 (n = 30) and those with flow <3 (n = 392) at in-hospital coronary arteriography had survival rates of 66% and 85%, respectively (p <0.12). Meanwhile, patients with coronary anterograde flow 3 (n = 189) and those with flow <3 (n = 233) had survival rates of 89% and 80%, respectively (p <0.04). By censored regression analysis, a negative correlation was found between coronary collateral flow degree and survival (p = 0.0498) and, inversely, a positive correlation was found between coronary anterograde flow degree and survival (p = 0.0053). By Cox multivariate analysis, the following variables showed significant correlations with long-term survival: global left ventricular ejection fraction (p = 0.0003), anterograde flow degree (p = 0.0006), collateral flow degree (negative correlation, p = 0.0179), and medical treatment (negative correlation, p = 0.0464). Thus, patients treated with intravenous streptokinase during AMI and with adequate coronary collateral circulation had a worse prognosis than those who developed adequate anterograde flow, probably because of residual myocardial ischemia. Such patients may benefit from coronary revascularization (angioplasty or surgery) to restore anterograde blood flow and minimize myocardium at risk.