Treatment Strategies for Acute Myocardial Infarction Complicated by Cardiogenic Shock in a Community Hospital
| Autor: | Mark A Rasak, Eric R. Bates, Robert J. Stomel |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Male
Patient Transfer Pulmonary and Respiratory Medicine medicine.medical_specialty Resuscitation Myocardial Infarction Shock Cardiogenic Hemodynamics Hospitals Community Critical Care and Intensive Care Medicine Coronary artery disease Risk Factors Internal medicine Myocardial Revascularization medicine Humans Thrombolytic Therapy Medical history Myocardial infarction Aged Intra-Aortic Balloon Pumping business.industry Cardiogenic shock Middle Aged medicine.disease Community hospital Surgery Survival Rate Cardiology Female Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | Chest. 105:997-1002 |
| ISSN: | 0012-3692 |
| Popis: | The risk and benefits of three treatment strategies were examined in 64 consecutive patients with acute myocardial infarction and cardiogenic shock. Thirteen patients received thrombolytic therapy (group 1), 29 patients received intra-aortic balloon pump counterpulsation support (group 2), and 22 patients were treated with combined thrombolytic therapy and intra-aortic balloon pump counterpulsation support (group 3). The groups were similar in regard to age, sex, medical history, hemodynamic data, and extent of coronary artery disease. Survival was improved in patients treated with combined thrombolytic therapy and intra-aortic balloon pump counterpulsation support (group 1, 23 percent; group 2, 28 percent; and group 3, 68 percent; p = 0.0049). Seven percent of the patients who remained at the community hospital survived vs 69 percent who were transferred to a tertiary care center (p0.001), and 17 percent survived who were treated medically vs 71 percent who received revascularization (p0.001). These findings suggest that patients who present to a community hospital in cardiogenic shock can have their conditions stabilized, and they can then be transferred to a tertiary care hospital for revascularization and have the same outcome as patients who initially present to tertiary care hospitals. |
| Databáze: | OpenAIRE |
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