Cardiovascular Statistics from the Good Practices in Cardiology Program – Data from a Brazilian Tertiary Public Hospital

Abstract Background The Good Practices in Cardiology Program is an initiative created by the Brazilian Society of Cardiology (SBC) to improve the quality of care of cardiovascular disease patients in Brazilian public hospitals. Objectives To characterize patients admitted to a tertiary public hospital with diagnosis of acute coronary syndrome (ACS) or heart failure (HF) and to evaluate performance indicators in both ACS and HF arms, with a pre-established target of 85% adherence to the SBC recommendations. Methods This was a descriptive cross-sectional study through data collection of patients hospitalized between May 2016 and September 2019. Results A total of 1,036 patients were included, 273 in the HF arm and 763 in the ACS arm. Mean age was 59.8 ± 12.0 years in the ACS and 57.0 ± 14.1 years in the HF, with a predominance of male patients in both groups. More than half of patients had some primary education and more than 90% reported a monthly income of less than five minimum wages. In ACS, the diagnosis of ACS with ST segment elevation was predominant (66.3%), and 2.9% of patients died. In HF, the most common etiology was Chagas disease (25.8%), and 17.9% died. Analysis of the performance indicators revealed an adherence rate higher than 85% to nine of the 12 indicators. Conclusion Quality programs are essential for improvement of quality of care. Performance indicators pointed to a good adherence to the SBC guidelines, mainly in the ACS arm.

摘要 背景：巴西心脏病学会（Brazilian Society of Cardiology, SBC）发起了心脏病学最佳实践项目，旨在提升巴西公立医院心血管疾病患者的医疗照护质量。研究目的：本研究旨在明确某三级公立医院收治的确诊急性冠脉综合征（acute coronary syndrome, ACS）或心力衰竭（heart failure, HF）患者的临床特征，并评估ACS与HF两个研究队列的绩效指标，预设目标为患者对巴西心脏病学会推荐方案的依从率达到85%。研究方法：本研究为描述性横断面研究，收集了2016年5月至2019年9月期间住院患者的相关数据。研究结果：共纳入1036例患者，其中HF队列273例，ACS队列763例。ACS队列患者平均年龄为59.8±12.0岁，HF队列患者平均年龄为57.0±14.1岁，两组均以男性患者居多。超过半数患者仅接受过初等教育，90%以上患者月收入低于5倍当地最低工资标准。ACS队列中，ST段抬高型急性冠脉综合征占比最高（66.3%），患者病死率为2.9%；HF队列中最常见的病因为恰加斯病（Chagas disease），患者病死率为17.9%。绩效指标分析显示，12项指标中有9项的依从率超过85%。研究结论：质量改进项目对提升医疗照护质量至关重要。绩效指标结果表明，本研究对巴西心脏病学会指南的依从性良好，其中ACS队列的依从表现更为突出。