Abstract

In 1968, 13 coronary care beds were established in eight small community hospitals in rural western North Carolina. Physician and nurse education programs in coronary care were conducted. The cumulative mortality rate in hospitalized patients with myocardial infarction prior to opening of these beds was 33% (40 of 120); the mortality during the three years of the program dropped to 20% (107 to 529). Death rates in anterolateral infarction showed a greater decrease (32% to 20%) than did the mortality in inferoposterior infarctions (24% to 19%). Improvement in survival occurred in the patients with potentially lethal arrhythmias and to a lesser extent in those with congestive heart failure. No statistically valid reduction in the death rate from myocardial infarction was demonstrated for the entire region by analysis of death certificate data.