Pajak Andrzej, Kawecka-Jaszcz Kalina, Jankowski Piotr, Bilo Grzegorz, Dubiel Jacek S, Maciejewicz Janusz, Piotrowski Wiesław, Smielak-Korombel Wanda, Tracz Wiesława
Zakład Epidemiologii Klinicznej i Badań Populacyjnych Instytutu Zdrowia Publicznego Collegium Medicum Uniwersytetu Jagiellońskiegio w Krakowie, 31-501 Kraków, ul. Kopernika 17.
Przegl Lek. 2003;60(3):136-41.
Hospitalization for ischaemic heart disease is a convenient moment to initiate pharmacological and non-pharmacological treatment as well as education of patients. The aim of the study was to assess the quality of medical care in the field of secondary prevention in patients hospitalized for ischaemic heart disease in cardiac departments of university and general hospitals in 1998/99 as compared with 1996/97.
Consecutive patients were recruited on the basis of hospital records review of six cardiac departments (three in the university and three in general hospitals) in 1998/99. Inclusion criteria were: age < or = 70 years, inhabitance in the city of Cracow and its province and hospitalization due to: myocardial infarction, unstable angina, coronary angioplasty or coronary-aortic bypass grafting.
Hospital records of the included patients were reviewed. Data on previous history of ischaemic heart disease, on risk factors (including smoking, hypertension, diabetes, dyslipidemia, obesity) and drugs prescribed at discharge were obtained based on a predefined questionnaire.
The frequency of blood pressure measurement in the first 24 hours of hospitalization was 88.8% in 1996/97 vs 95.7% in 1998/99 (p < 0.001). In the first 24 hours after admission total cholesterol concentration was measured in 32.8% and 45.0% of patients (p < 0.001), HDL cholesterol in 30.2% and 41.9% (p < 0.001) and triglycerides in 32.3% and 44.5% (p < 0.001), respectively. Both height and body mass were documented in 54.3% and 61.7% (p < 0.05) of the reviewed charts. Antiplatelet drugs were prescribed at discharge in 86.7% and 90.7% of patients (p < 0.05), beta-blockers in 66.4% and 61.9%, ACE inhibitors in 50.2% and 52.8%, while lipid lowering drugs in 27.1% and 41.6% (p < 0.001), respectively.
In 1998/99 compared with 1996/97 the quality of care in the field of secondary prevention of ischaemic heart disease was improved in cardiac departments of university and general hospitals in Cracow.
因缺血性心脏病住院是启动药物和非药物治疗以及对患者进行教育的便利时机。本研究的目的是评估1998/99年与1996/97年相比，大学医院和综合医院心脏科因缺血性心脏病住院患者二级预防领域的医疗质量。
1998/99年，根据对六个心脏科（三所大学医院和三所综合医院各一个）的医院记录审查，连续招募患者。纳入标准为：年龄≤70岁，居住在克拉科夫市及其省份，且因以下原因住院：心肌梗死、不稳定型心绞痛、冠状动脉成形术或冠状动脉搭桥术。
对纳入患者的医院记录进行审查。根据预先定义的问卷，获取缺血性心脏病既往史、危险因素（包括吸烟、高血压、糖尿病、血脂异常、肥胖）以及出院时所开药物的数据。
1996/97年住院后24小时内血压测量频率为88.8%，1998/99年为95.7%（p<0.001）。入院后24小时内，分别有32.8%和45.0%的患者测量了总胆固醇浓度（p<0.001），30.2%和41.9%的患者测量了高密度脂蛋白胆固醇（p<0.001），32.3%和44.5%的患者测量了甘油三酯（p<0.001）。在审查的病历中，记录身高和体重的分别占54.3%和61.7%（p<0.05）。出院时，86.7%和90.7%的患者开具了抗血小板药物（p<0.05），66.4%和61.9%的患者开具了β受体阻滞剂，50.2%和52.8%的患者开具了血管紧张素转换酶抑制剂，而开具降脂药物的患者分别占27.1%和41.6%（p<0.001）。
与1996/97年相比，1998/99年克拉科夫市大学医院和综合医院心脏科缺血性心脏病二级预防领域的医疗质量有所提高。
