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ICU Care for STEMI Associated With Improved Mortality Rates

THURSDAY, June 13, 2019 -- Among ST-segment elevation myocardial infarction (STEMI) patients who could be treated in an intensive care unit (ICU) or a non-ICU unit, those treated in the ICU have improved mortality rates, according to a study published online June 4 in The BMJ.

Thomas S. Valley, M.D., from the University of Michigan in Ann Arbor, and colleagues evaluated the effect of ICU admission on mortality among 109,375 Medicare beneficiaries (≥65 years) with STEMI versus admission to a non-ICU unit (general/telemetry ward or intermediate care).

The researchers found that hospitals in the top quarter of ICU admission rates admitted ≥85 percent of STEMI patients to an ICU. ICU admission was associated with lower 30-day mortality rates compared with non-ICU admission (absolute decrease 6.1 percentage points; 95 percent confidence interval, −11.9 to −0.3) among patients who received ICU care dependent on their proximity to a hospital in the top quarter of ICU admission rates. Among patients with non-STEMI, ICU admission was not associated with differences in mortality (absolute increase, 1.3 percentage points; 95 percent confidence interval, −0.9 to 3.4), in line with previous evidence.

"An urgent need exists to identify which patients with STEMI benefit from ICU admission and what about ICU care is beneficial," the authors write.

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Posted: June 2019