Abstract 19705: Real-time Home-to-hospital Ischemic Time Dashboard in Patients With ST segment Elevation Myocardial Infarction Results in Significant Improvement of the Logistic Chain and Lower Short-term Mortality

Autor: Maaike Hermans, Matthijs Velders, Martin Smeekes, Olivier Drexhage, Timon Ytsma, Martin Schalij, Victor Umans
Rok vydání: 2015
Předmět:
Zdroj: Circulation. 132
ISSN: 1524-4539
0009-7322
DOI: 10.1161/circ.132.suppl_3.19705
Popis: Introduction: Timely reperfusion with primary percutaneous coronary intervention (PCI) in ST segment elevation myocardial infarction (STEMI) patients is associated with superior clinical outcomes. Aiming to reduce ischemic time, an innovative system for H2H time monitoring was implemented. The objective of this study was to assess the results of a real time home-to-hospital (H2H) dashboard for monitoring and evaluation of ischemic time in STEMI patients. Methods: Ischemic time in STEMI patients transported by Emergency Medical Services (EMS) and treated with primary PCI in the Medical Center Alkmaar before (n=843) and after the implementation of the H2H dashboard (n=441) was compared. Time points in the H2H dashboard were semi-automatically registered, enabling evaluation by the EMS and Cardiology departments. Before implementation of the H2H dashboard, time points were recorded on paper and retrospectively collected. Results: Median treatment delay, first medical contact (FMC) to balloon time and door-to-balloon time were significantly shorter in the H2H group (treatment delay 142 minutes [IQR 103;221 minutes] vs. 181 minutes [IQR 134;286 minutes] P value Conclusions: After implementation of the H2H dashboard, significantly shorter ischemic time was observed. The use of the H2H dashboard was independently associated with shorter time delays. Short-term mortality was significantly lower in the H2H group due to lower incidence of cardiogenic shock.
Databáze: OpenAIRE