OBJECTIVES: More patients with chronic diseases in China will be treated in primary hospitals. This study discribed the risk level and distribution of atherosclerotic cardiovascular disease (ASCVD) patients in a a county hospital, and evaluated effectiveness of CDSS on ASCVD key risk factors control.

METHODS: The data of were obtained from Yongcheng Central Hospital. A CDSS was installed in the physician workstation to complete ASCVD risk assessment, diagnosis and treatment based on clinical guideline. Patients with ASCVD diagnosis and received at least 2 CDSS interventions within 3 months in 2021 were enrolled. Control rate of different lipoproteins including Triglycerides (TG), High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL) and Serum Total Cholesterol (TC) were analysed. Statistical analysis was performed using SPSS (v21.0)

RESULTS: Among 1126 ASCVD patients, 833(73.98%) were assessed as very high risk, 263(23.36%) as high risk, 0(0%) as intermediate risk and 30(2.66%) as low risk. At baseline, TG, HDL, LDL and TC level in these patients were (1.49 ± 1.04), (2.41 ± 1.06), (1.35 ± 0.73) and (4.23 ± 1.22) mmol/L, with respectively 63.41%, 69.54%, 62.88% and 65.54% patients achieved LDL-C target. 64.71% of very high risk patients achieved LDL target at first visit and 74.23% at the second visit, with significant difference (P=0.02). 59.55% of high risk patients achieved LDL target at the first visit and 80. 63% at the second visit (P=0.03). 76.67% of low-to-moderate risk patients achieved LDL target at the first visit and 83. 33% at the second visit, with no statistically significant difference between two visits.

CONCLUSIONS: The ASCVD patients risk distribution in county hospitals is not optimistic, with the majority are high-risk patients, and the control rate of LDL-C is low in general. The application of CDSS showed improvement on the LDL control rate, especially in patients with high risk and very high risk.