BACKGROUND: Although thrombolytic therapy improves the outcome of @entity583 , it is associated with increased risks of @entity64 and @entity548 ; these risks may outweigh the benefits of therapy. The risks and benefits of thrombolysis, for any individual clinical situation, can be explicitly estimated by means of decision analysis. HYPOTHESIS: The aim of this study was to compare the actual use of thrombolytic agents for suspected @entity583 ( @entity583 ) with the management preferred by a decision analysis model. METHODS: Admission data prospectively obtained in 262 consecutive @entity1 admitted to a rural community hospital's coronary care unit with suspected @entity583 , as well as clinical decisions and outcomes, were reviewed and analyzed. RESULTS: Seventeen deaths from @entity583 and no major @entity64 were observed, compared with 18.30 deaths and 0.85 major @entity64 predicted by a decision analysis model. Forty-seven of 84 @entity1 with confirmed @entity583 and 3 of 178 without @entity583 were given a thrombolytic agent, compared with 65 @entity1 with and 7 without @entity583 who had decision analysis-guided therapy. Decision analysis-guided therapy could have saved 3.7 additional lives and gained 29.6 life years, but produced 0.4 extra @entity64 . Changing the quality adjustment for @entity64 or @entity712 would not have altered the treatment preferred by decision analysis in any of the 262 cases studied. Some @entity1 were predicted to benefit considerably from thrombolysis with little extra risk of @entity64 and vice versa: all cases must, therefore, be assessed individually. CONCLUSIONS: A decision analysis model can guide thrombolytic therapy by promptly defining its risks and benefits.

Thrombolytic therapy guided by a decision analysis model: are there potential benefits for XXXX management?

@entity1 :: ('9606', 'Species') :: ['patients'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity64 :: ('MESH:D020521', 'Disease') :: ['strokes', 'stroke'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity583 :: ('MESH:D009203', 'Disease') :: ['AMI', 'myocardial infarction', 'acute myocardial infarction']
@entity1 :: (9606,Species) :: ['patient']
