Stross J K, Willis P W, Reynolds E W, Lewis R E, Schatz I J, Bellfy L C, Copp J
Ann Intern Med. 1976 Dec;85(6):709-13. doi: 10.7326/0003-4819-85-6-709.
A prospective study was undertaken from 1969 to 1974 to evaluate a program establishing coronary care units in small community hospitals. Crude mortality rates from acute myocardial infarction in these small hospitals were 14.5%, slightly higher but not statistically different from concurrently collected data in three larger comparision hospitals (11.5%). Mutivariate discriminate analysis of clinical characteristics was used to calculate a risk score for each patient admitted. Observed deaths exceeded expected deaths (134 versus 119) (P greater than 0.30) in small hospitals but observed deaths were less than expected (55 versus 77)(P less than 0.05) in comparison hospitals. Mortality was significantly greater in those units admitting fewer than 60 patients with infarctions yearly (20.9%) than in those admitting more than 60 (10.7%) (P less than 0.001). These data suggest that coronary care units in small community hospitals can provide adequate coronary care, but their level of performance drops when fewer than 60 patients with infarctions are admitted yearly.
1969年至1974年进行了一项前瞻性研究，以评估在小型社区医院设立冠心病监护病房的项目。这些小型医院急性心肌梗死的粗死亡率为14.5%，略高于同时期在三家较大对照医院收集的数据（11.5%），但无统计学差异。对临床特征进行多变量判别分析，为每位入院患者计算风险评分。小型医院观察到的死亡人数超过预期死亡人数（134例对119例）（P>0.30），而对照医院观察到的死亡人数少于预期（55例对77例）（P<0.05）。每年收治心肌梗死患者少于60例的病房死亡率（20.9%）显著高于收治多于60例的病房（10.7%）（P<0.001）。这些数据表明，小型社区医院的冠心病监护病房可以提供足够的冠心病护理，但当每年收治的心肌梗死患者少于60例时，其护理水平会下降。
