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A European benchmarking system to evaluate in-hospital mortality rates in acute coronary syndrome: The EURHOBOP project.

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dc.contributor.author Dégano, Irene R.
dc.contributor.author Subirana Cachinero, Isaac
dc.contributor.author Torre, Marina
dc.contributor.author Grau Magaña, Maria
dc.contributor.author Vila, Joan
dc.contributor.author Fusco, Danilo
dc.contributor.author Kirchberger, Inge
dc.contributor.author Ferrières, Jean
dc.contributor.author Malmivaara, Antti
dc.contributor.author Azevedo, Ana
dc.contributor.author Meisinger, Christa
dc.contributor.author Bongard, Vanina
dc.contributor.author Farmakis, Dimitrios
dc.contributor.author Davoli, Marina
dc.contributor.author Häkkinen, Unto
dc.contributor.author Araújo, Carla
dc.contributor.author Lekakis, John
dc.contributor.author Elosua Llanos, Roberto
dc.contributor.author Marrugat de la Iglesia, Jaume
dc.date.accessioned 2015-04-22T11:57:03Z
dc.date.available 2015-04-22T11:57:03Z
dc.date.issued 2015
dc.identifier.citation Dégano IR, Subirana I, Torre M, Grau M, Vila J, Fusco D. A European benchmarking system to evaluate in-hospital mortality rates in acute coronary syndrome: The EURHOBOP project. Int J Cardiol. 2015 Mar 1;182:509-16. doi: 10.1016/j.ijcard.2015.01.019
dc.identifier.issn 0167-5273
dc.identifier.uri http://hdl.handle.net/10230/23458
dc.description.abstract BACKGROUND: Hospital performance models in acute myocardial infarction (AMI) are useful to assess patient management. While models are available for individual countries, mainly US, cross-European performance models are lacking. Thus, we aimed to develop a system to benchmark European hospitals in AMI and percutaneous coronary intervention (PCI), based on predicted in-hospital mortality. METHODS AND RESULTS: We used the EURopean HOspital Benchmarking by Outcomes in ACS Processes (EURHOBOP) cohort to develop the models, which included 11,631 AMI patients and 8276 acute coronary syndrome (ACS) patients who underwent PCI. Models were validated with a cohort of 55,955 European ACS patients. Multilevel logistic regression was used to predict in-hospital mortality in European hospitals for AMI and PCI. Administrative and clinical models were constructed with patient- and hospital-level covariates, as well as hospital- and country-based random effects. Internal cross-validation and external validation showed good discrimination at the patient level and good calibration at the hospital level, based on the C-index (0.736-0.819) and the concordance correlation coefficient (55.4%-80.3%). Mortality ratios (MRs) showed excellent concordance between administrative and clinical models (97.5% for AMI and 91.6% for PCI). Exclusion of transfers and hospital stays ≤1day did not affect in-hospital mortality prediction in sensitivity analyses, as shown by MR concordance (80.9%-85.4%). Models were used to develop a benchmarking system to compare in-hospital mortality rates of European hospitals with similar characteristics. CONCLUSIONS: The developed system, based on the EURHOBOP models, is a simple and reliable tool to compare in-hospital mortality rates between European hospitals in AMI and PCI.
dc.description.sponsorship This work was supported by the SANCO EAHC grants (EUPHORIC 2003/134 and EURHOBOP 2008/1312), the Health Institute Carlos IIIFEDER (HERACLES Spanish Cardiovascular Research Network RD06/ 0009 and RD12/0042, CB06/02/0029 and CP12/03287 to MG) and the Catalan Agency for Management of University and Research Grants (2005SGR00577, 2009SGR1195 and 2014SGR240, and 2011BP-B00169 postdoctoral contract to IRD — Beatriu de Pinós Program co-financed by the European Commission
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof International Journal of Cardiology 2015 Mar 1;182:509-16
dc.rights © Elsevier http://dx.doi.org/10.1016/j.ijcard.2015.01.019
dc.subject.other Infart de miocardi
dc.subject.other Mortalitat
dc.title A European benchmarking system to evaluate in-hospital mortality rates in acute coronary syndrome: The EURHOBOP project.
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.ijcard.2015.01.019
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion

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