Trial reportBMJ (Clinical research ed.)2015
Comparison of hospital variation in acute myocardial infarction care and outcome between Sweden and United Kingdom: population based cohort study using nationwide clinical registries.
Trial report in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01359033 (Compare the Patient Risk and Between-hospital Variation in Myocardial Infarction Mortality in the United Kingdom and Sweden), which is not on this map. Cited by 45 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Compare the Patient Risk and Between-hospital Variation in Myocardial Infarction Mortality in the United Kingdom and Sweden
Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it.
- European Society of Cardiology methodology for the development of quality indicators for the quantification of cardiovascular care and outcomes.European heart journal. Quality of care & clinical outcomes · 2022Pooled it
- Trial
- Article
- Prognostic value of TIMI risk score combined with systemic immune-inflammation index and lipoprotein(a) in patients with ST-Segment elevation myocardial infarction after percutaneous coronary intervention.International journal of cardiology. Heart & vasculature · 2025Article
- Sex-based analysis of NSTEMI processes of care and outcomes by hospital: a nationwide cohort study.European heart journal. Quality of care & clinical outcomes · 2024Article
- Lack of associations between hospital rating and outcomes in patients with an acute coronary syndrome.BMJ open quality · 2024Article
- Inequalities in care delivery and outcomes for myocardial infarction, heart failure, atrial fibrillation, and aortic stenosis in the United Kingdom.The Lancet regional health. Europe · 2023Review
- Presentation, care, and outcomes of patients with NSTEMI according to World Bank country income classification: the ACVC-EAPCI EORP NSTEMI Registry of the European Society of Cardiology.European heart journal. Quality of care & clinical outcomes · 2023Article
- Article
- Stability of hospital quality indicators over time: A multi-year observational study of German hospital data.PloS one · 2023Observational
- Variation in revascularisation use and outcomes of patients in hospital with acute myocardial infarction across six high income countries: cross sectional cohort study.BMJ (Clinical research ed.) · 2022Article
- The Impact of Diabetes on Vascular Disease: Progress from the Perspective of Epidemics and Treatments.Journal of diabetes research · 2022Review
- The impact of quality on hospital choice. Which information affects patients' behavior for colorectal resection or knee replacement?Health care management science · 2021Article
- Current Status and Hospital-Level Differences in Care and Outcomes of Patients With Acute Non-ST-Segment Elevation Myocardial Infarction in China: Insights From China Acute Myocardial Infarction Registry.Frontiers in cardiovascular medicine · 2021Article
- Expansion of off-site percutaneous coronary intervention centres significantly reduces ambulance driving time to primary PCI in the Netherlands.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2020Article
- Article
- European survey on acute coronary syndrome diagnosis and revascularisation treatment: Assessing differences in reported clinical practice with a focus on strategies for specific patient cases.Journal of evaluation in clinical practice · 2020Article
- Association of Hospital-Level Differences in Care With Outcomes Among Patients With Acute ST-Segment Elevation Myocardial Infarction in China.JAMA network open · 2020Article
- Access to reperfusion therapy and mortality outcomes in patients with ST-segment elevation myocardial infarction under universal health coverage in Thailand.BMC cardiovascular disorders · 2020Article
- Statistics on mortality following acute myocardial infarction in 842 897 Europeans.Cardiovascular research · 2020Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
12 authors.
Funding
Abstract
objectiveTo assess the between hospital variation in use of guideline recommended treatments and clinical outcomes for acute myocardial infarction in Sweden and the United Kingdom.
designPopulation based longitudinal cohort study using nationwide clinical registries. SETTING AND
participantsNationwide registry data comprising all hospitals providing acute myocardial infarction care in Sweden (SWEDEHEART/RIKS-HIA, n=87; 119,786 patients) and the UK (NICOR/MINAP, n=242; 391,077 patients), 2004-10.
main outcome measuresBetween hospital variation in 30 day mortality of patients admitted with acute myocardial infarction.
resultsCase mix standardised 30 day mortality from acute myocardial infarction was lower in Swedish hospitals (8.4%) than in UK hospitals (9.7%), with less variation between hospitals (interquartile range 2.6% v 3.5%). In both countries, hospital level variation and 30 day mortality were inversely associated with provision of guideline recommended care. Compared with the highest quarter, hospitals in the lowest quarter for use of primary percutaneous coronary intervention had higher volume weighted 30 day mortality for ST elevation myocardial infarction (10.7% v 6.6% in Sweden; 12.7% v 5.8% in the UK). The adjusted odds ratio comparing the highest with the lowest quarters for hospitals' use of primary percutaneous coronary intervention was 0.70 (95% confidence interval 0.62 to 0.79) in Sweden and 0.68 (0.60 to 0.76) in the UK. Differences in risk between hospital quarters of treatment for non-ST elevation myocardial infarction and secondary prevention drugs for all discharged acute myocardial infarction patients were smaller than for reperfusion treatment in both countries.
conclusionBetween hospital variation in 30 day mortality for acute myocardial infarction was greater in the UK than in Sweden. This was associated with, and may be partly accounted for by, the higher practice variation in acute myocardial infarction guideline recommended treatment in the UK hospitals. High quality healthcare across all hospitals, especially in the UK, with better use of guideline recommended treatment, may not only reduce unacceptable practice variation but also deliver improved clinical outcomes for patients with acute myocardial infarction. Clinical trials registration Clinical trials NCT01359033.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.