Urban and rural implementation of pre-hospital diagnosis and direct referral for primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction
| Autor: | Troels Martin Hansen, Christian Juhl Terkelsen, Hans Erik Bøtker, Jacob Thorsted Sørensen, Sven Trautner, Henning Rud Andersen, Bjarne L. Nørgaard, Jens Flensted Lassen |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Emergency Medical Services Time Factors Referral medicine.medical_treatment Denmark Myocardial Infarction Kaplan-Meier Estimate Rural Health Electrocardiography Angioplasty medicine Emergency medical services Humans Myocardial infarction Prospective Studies cardiovascular diseases Angioplasty Balloon Coronary Intensive care medicine Prospective cohort study Referral and Consultation Aged business.industry Urban Health Percutaneous coronary intervention Middle Aged medicine.disease Telemedicine Hospitalization surgical procedures operative Emergency medicine Conventional PCI Female Myocardial infarction diagnosis Cardiology and Cardiovascular Medicine business |
| Zdroj: | Sørensen, J T, Terkelsen, C J, Nørgaard, B L, Trautner, S, Hansen, T M, Bøtker, H E, Lassen, J F & Andersen, H R 2011, ' Urban and rural implementation of pre-hospital diagnosis and direct referral for primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction ', European Heart Journal (English Edition), vol. 32, no. 4, pp. 430-436 . https://doi.org/10.1093/eurheartj/ehq437 Sørensen, J T, Terkelsen, C J, Nørgaard, B L, Trautner, S, Hansen, T M, Bøtker, H E, Lassen, J F & Andersen, H R 2011, ' Urban and rural implementation of pre-hospital diagnosis and direct referral for primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction ', European Heart Journal (English Edition), vol. 32, no. 4, pp. 430-6 . https://doi.org/10.1093/eurheartj/ehq437 |
| DOI: | 10.1093/eurheartj/ehq437 |
| Popis: | Aims Primary percutaneous coronary intervention (PCI) is the preferred treatment for ST-elevation myocardial infarction (STEMI). The distance to primary PCI centres and the inherent time delay in delivering primary PCI, however, limit widespread use of this treatment. This study aimed to evaluate the impact of pre-hospital diagnosis on time from emergency medical services contact to balloon inflation (system delay) in an unselected cohort of patients with STEMI recruited from a large geographical area comprising both urban and rural districts. Methods and results From February 2004 until January 2007, data on pre-hospital timing and transport distance were prospectively recorded. Patients were divided into groups depending on achievement of pre-hospital diagnosis and/or direct referral to a primary PCI centre. Seven hundred and fifty-nine consecutive STEMI patients were included. In patients with a pre-hospital diagnosis and direct referral, the system delay was 92 vs. 153 min in patients without pre-hospital diagnosis ( P < 0.001). Patients from rural areas were transported a median of 30 km longer than patients from urban areas; however, this prolonged the system delay by only 9 min. Conclusion Pre-hospital electrocardiographic (ECG) diagnosis and direct referral for primary PCI enables STEMI patients living far from a PCI centre to achieve a system delay comparable with patients living in close vicinity of a PCI centre. |
| Databáze: | OpenAIRE |
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