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ncdr

ACTION Registry™ (Acute Coronary Treatment and Intervention Outcomes Network) Initial Report 1st Quarter 2007 Results Report prepared by:. www. ncdr.com. Background. Recent studies have demonstrated that guidelines adherence is sub-optimal for a large proportion of ACS patients.

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ncdr

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  1. ACTION Registry™(Acute Coronary Treatment and Intervention Outcomes Network)Initial Report1st Quarter 2007 ResultsReport prepared by: www. ncdr.com

  2. Background • Recent studies have demonstrated that guidelines adherence is sub-optimal for a large proportion of ACS patients. • The ACTION Registry has been created to enable hospitals to measure and improve their performance in treating patients with ACS against national benchmarks. • Contained in this report are performance information from the 2006-2007 harvest from CRUSADE and the ACTION Registry.

  3. The ACTION Registry • Represents the merger of two of the nation’s premier ACS registries: • NRMI (National Registry of Myocardial Infarction) • CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC and AHA Guidelines) • Unified under the leadership and support of NCDR™ : • Guidelines, performance indictors, and data standard alignment • Clinical/technical/contract support • Training and orientation www. ncdr.com

  4. Goals of the ACTION Registry • The nation’s ACS surveillance system • Assess characteristics, treatments, and outcomes of patients hospitalized with STEMI and NSTEMI • Optimize the care and outcomes of ACS patients • Implement ALL evidence-based guideline recommendations in clinical practice • Assure that the right things are done right (safe and timely). • Facilitate efforts to improve ACS care quality and safety via novel QI improvement methods

  5. ACTION QI Tool Development • Quarterly feedback reports • Individualized GAP analysis • On-line, real-time summaries • QI tool kits • D2B tool kits • Monthly Webcasts • Regional group meetings • Take ACTION™ Campaign

  6. 2006-07 Data Submission Summary Admission # of # of # of Timeframe Sites NSTEMI Records STEMI Records ACTION Jan. 1, 2007 – 227 6,917 4,259 Mar. 31, 2007 CRUSADE April 1, 2006 – 280 20,084 4,391 Dec. 31, 2006

  7. ACTION Registry 2007 Patient Enrollment Number of Patients enrolled

  8. Complexity of NSTEMI PtsBaseline Characteristics NSTEMIVariable(n = 26,902) Mean age ± SD (yrs) 69 ± 14 Female Diabetes mellitus Prior MI Prior CHF Prior PCI Prior CABG 40% 33% 29% 16% 23% 19% ACTION/CRUSADE DATA: April 1, 2006 – May 31, 2007 (n=26,902)

  9. Hospital Presentation VariableNSTEMI (n = 26,902) Qualifying criteria ST-segment depression Transient ST-segment elevation Presenting characteristics Tachycardia Hypotension Signs of CHF 25% 4% 22% 3% 22% ACTION/CRUSADE DATA: April 1, 2006 – May 31, 2007 (n=26,902)

  10. In-Hospital Outcomes VariableNSTEMI (n = 26,902) Death Re-infarction CHF Cardiogenic Shock Stroke RBC Transfusion* 3.8% 1.5% 6.8% 2.4% 0.7% 8.9% *Excluding CABG patients ACTION/CRUSADE DATA: April 1, 2006 – May 31, 2007 (n=26,902)

  11. NSTEMI Acute Medications ACTION/CRUSADE DATA: April 1, 2006 – May 31, 2007

  12. NSTEMI Invasive Cardiac Procedures ACTION/CRUSADE DATA: April 1, 2006 – May 31, 2007

  13. NSTEMI Discharge Medications % Use *LVEF < 40%, CHF, DM, HTN# Known hyperlipidemia,  TC,  LDL ACTION/CRUSADE DATA: April 1, 2006 – May 31, 2007 (n= 26,902)

  14. NSTEMI Discharge Interventions ACTION/CRUSADE DATA: April 1, 2006 – May 31, 2007

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