Ventajas de la guardia de cardiología en un hospital secundario en el tratamiento de los pacientes con síndrome coronario agudo

Abstract

Introduction and objectivesHospital care by a cardiologist has been shown to improve the prognosis of patients admitted with acute coronary syndrome (ACS), although on-call cardiologists are not common in second-level hospitals. MethodsRetrospective analysis of a cohort of patients admitted due to ACS using propensity-score matching to assess differences between both periods. ResultsThe study included 2257 patients, of which 33.2% were admitted during the cardiologist on-call period, with 734 pairs of patients being obtained using propensity score-matching. A shorter hospital stay was observed in patients admitted during the cardiologist on-call period (5.2 vs 6.3 days; P<.01) and this was one of the variables independently associated with the shorter hospital stay variable. Within the cardiologist on-call period there was a shorter stay in the intensive care unit (47.7% vs 54.5%; P=.03), mainly by the non-ST-elevation ACS patients (33.2% vs 19.1%; P<.01), and in weekdays. There were also higher rates of angiography and revascularisation within the first 24h of admission (76.2% vs 66.0%; P<.01). There were no differences in-hospital mortality or within the first 12 months after discharge between both periods. ConclusionsImplementation of on-call cardiology shortened the time to revascularization and hospital stay, as well as reducing the length of intensive care unit stay. These results support the usefulness of an on-call cardiologist in non-tertiary hospitals, at least for the benefit of ACS patients.