Impact of Chest Pain Protocol with Access to Telemedicine on Implementation of Pharmacoinvasive Strategy in a Private Hospital Network
| Autor: | José Carlos Teixeira Garcia, Thiago Macedo, Sheila Aparecida Simões, Valter Furlan, Roberto Nery Dantas, Marcio Campos Sampaio, Tiago Frigini, Liliane Rocha, Bernardo B.C. Lopes, Mariana Yumi Okada, Pedro Gabriel Melo de Barros e Silva, Roger Pereira Oliveira |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Telemedicine medicine.medical_specialty Inservice Training Health Informatics Hospital mortality 030204 cardiovascular system & hematology Chest pain Hospitals Private 03 medical and health sciences 0302 clinical medicine Clinical Protocols Health Information Management St elevation myocardial infarction medicine Humans In patient Hospital Mortality cardiovascular diseases 030212 general & internal medicine Myocardial infarction Aged Hospital network Protocol (science) Information Dissemination business.industry General Medicine Middle Aged medicine.disease Emergency medicine ST Elevation Myocardial Infarction Female Medical emergency medicine.symptom business Brazil |
| Zdroj: | Telemedicine and e-Health. 22:549-552 |
| ISSN: | 1556-3669 1530-5627 |
| Popis: | Brazilian registries have shown a gap between evidence-based therapies and real treatments. We aim to compare the use of the pharmacoinvasive strategy and mortality in patients with ST elevation myocardial infarction (STEMI) transferred pre- and post-chest pain protocol with access to telemedicine (CPPT) in a private hospital network.A CPPT was implemented in 22 private emergency departments in 2012. Emergency physicians and nurses of all facilities were trained to disseminate the information to comply with a chest pain protocol focusing on reperfusion therapy (pharmacoinvasive strategy) for STEMI. To conduct clinical discussions using telemedicine, a cardiologist from a reference hospital in cardiology (RHC) was available 24 h/day, 7 days/week. Using the database of all consecutive admissions, we compared the data of patients with STEMI transferred to the RHC in 2011 (pre-CPPT) and 2013-2014 (post-CPPT).We included 376 patients (113 pre-CPPT and 263 post-CPPT) with STEMI. All patients admitted in the RHC were transferred from the 22 emergency departments. Comparing pre-CPPT and post-CPPT, we did not find differences regarding age, gender, hypertension, dyslipidemia, diabetes, smoking, previous myocardial infarction, or Killip classification. However, the use of CPPT was associated with a greater use of pharmacoinvasive strategy (55.8% versus 38%; p = 0.002) and a trend toward lower in-hospital mortality (3% versus 8%; p = 0.06).The implementation of a CPPT was associated with a significant increase in the use of pharmacoinvasive strategy in patients with STEMI and a trend toward reduced in-hospital mortality in a private hospital network. |
| Databáze: | OpenAIRE |
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