Does monitoring in a coronary care unit reduce mortality and improve resuscitation rates in patients with acute myocardial infarction compared to standard medical wards?
Admission to a dedicated coronary care unit significantly reduces mortality and improves resuscitation success in patients with acute myocardial infarction compared to general medical wards.
The course of 100 consecutive patients with proven acute myocardial infarction admitted to medical wards at Denver Veterans Administration Hospital (VAH) were compared with 105 monitored in a coronary care unit at Colorado General Hospital (CGH) over a 17-month period. Clinical characteristics and electrocardiographic features were similar in the two groups and care was by identical physicians. Arrhythmias were observed in 80% of monitored patients and 58% at VAH. Ventricular fibrillation in "good risk" patients occurred in 9% at CGH and 19% at VAH. Fifty-seven percent of monitored and 12% of unmonitored patients were resuscitated and survived. Resuscitation of all first week cardiac arrests occurred in 37% and 4% of the patients respectively. Total mortality at VAH was 33% and at CGH, 19%. Results stress the value of coronary care units in prevention of ventricular fibrillation and increasing successful resuscitation.
RobertJ. Marshall (Sun,) studied this question.