Swan-Ganz catheter use and mortality of myocardial infarction patients.
Blumberg, Mark S
Date of Pub
Binns, Gregory S
Using the 1989 Medicare provider analysis and review (MEDPAR) file, we calculated a 30-day indirectly standardized mortality
ratio (SMR) for all "fresh" acute myocardial infarction (AMI) Medicare aged cases (i.e., fresh AMI patients are those who
had not reported an AMI in the prior 8 weeks) at 2,900 hospitals, as well as an indirectly standardized procedure ratio (SPR)
of Swan-Ganz catheter (SGC) use for these AMI cases at each hospital. Cases at hospitals with higher SGC SPRs also had higher
SMRs. This positive association persisted when hospitals were further stratified by their annual volume of fresh AMI cases.
We believe that our use of cases as the unit of observation, stratified by the SGC SPR of their hospital, avoids some case
selection bias in observational studies directly comparing risk-adjusted mortality of cases with and without SGC.