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Colette Derworiz
Calgarians have a better chance of surviving their first heart attack than most other Canadians, a new study suggests.
A report released Tuesday by the Canadian Institute for Health Information shows eight per cent of patients entering Calgary hospitals for heart attacks die within 30 days. The national average, however, is 12.65 per cent.
And four of the five regions with the best results across Canada, all superior to the national average, are in Alberta. Along with Calgary they include the health authorities for the regions of Lakeland, east of Edmonton, David Thompson, southwest of Red Deer, and Capital City, in Edmonton.
The East Central Health Authority, east of Red Deer, had the second-highest mortality rate.
Medical officials believe procedural changes have led to the improved results.
"One of the things we've been very successful at is implementing protocols to triage those patients in emergency," said Carol Rimmer, director of quality improvement and health information at the Calgary Regional Health Authority.
"So as soon as they come in and are identified as having heart problems, they get immediately directed to cardiac care so we are treating them as quickly as possible.
"Early intervention is one of the key factors in positive outcomes," she added.
Nonetheless, the study showed the chances of leaving the hospital after a first heart attack are steadily increasing across the country, said the institute's chair, Michael Decter, a former deputy minister of health in Ontario.
"The good news is that a patient's chances of surviving a heart attack are improving," said Decter.
The study showed considerable variation between the national average and some regions, such as in St. John's, Nfld., where the rate was more than 18 per cent.
Lyle Walton, director of public information and communication for the Heart and Stroke Foundation of Alberta, Northwest Territories and Nunavut, said the fact Calgary is in good economic shape would affect the findings.
"We have great, not just good, but great facilities in Calgary and the wealth of well-trained doctors and researchers," he said. "We are in pretty good shape."
Decter also said the report suggests Canada has too many medical centres doing complex procedures such as coronary bypass operations.
"Simply put, the data suggest that we have too many centres undertaking complex procedures such as heart surgery. The results may be unnecessary complications and unnecessary deaths," said Decter.
The annual snapshot of the country's health care system showed patients who underwent specialized surgeries in hospital that perform many such operations had better survival rates and fewer post-operative complications than people who had the procedure in facilities that rarely do such operations.
For instance, patients cared for in hospitals that did fewer than 500 surgeries a year were 39 per cent more likely to die than patients operated on in hospitals that specialize in the procedure.
"I think that it really emphasizes and provides support for the intuitive view that if you do a procedure more often, you'll get better at it," Gary Mar, minister of Alberta Health and Wellness, said at the news conference in Toronto, where the report was made public.
"So one might ask on a personal level: Would you rather have your coronary bypass surgery done by somebody who had done the procedure once a week for the last three years or somebody who did one last year and wants to do yours today?"
"The evidence has become very clear on the relationship between volumes and outcomes and I think it is a troubling aspect which is evident in the report," Decter said.
Troubling because your chances of having such surgeries in a high-volume facility appear to vary depending on where you live.
Only four per cent of people undergoing bypass operations in Ontario did so in hospitals that performed fewer than 500 such operations a year. But that figure climbed to 16 per cent in British Columbia, 23 per cent in Atlantic Canada, 33 per cent on the Prairies and 47 per cent in Quebec, Decter said.
Still, there was much good news in the report.
Canadians are living longer, Decter noted. Life expectancy has increased by six years since the 1970s.
And the survival rates for Canadians who suffer heart attacks or who undergo organ transplants are also on the rise.
Five-year survival rates were more than 75 per cent for heart and liver transplant patients operated on between 1992 and 1998, and more than 85 per cent for patients getting a kidney transplant during the same period.
The top health authorities for heart attack survival rates, according to a health study.
Copyright © 2001 CanWest Interactive.
This article posted June 3, 2001.