[Reperfusion delays in acute coronary syndromes with ST segment elevation (STEMI) depending on prehospital care]
1Centre hospitalier départementale Vendée, Les Oudairies, 85925 La Roche-sur-Yon cedex 9, France.
Insights
Directly contacting emergency services for ST-elevation myocardial infarction (STEMI) significantly reduces reperfusion times. This study highlights the importance of streamlined patient pathways for faster artery reperfusion in STEMI cases.
Area of Science:
- Cardiology
- Emergency Medicine
- Health Services Research
Background:
- ST-elevation myocardial infarction (STEMI) is a leading cause of death in France.
- Timely reperfusion is critical for reducing STEMI morbidity and mortality.
- Patient care pathways significantly influence reperfusion delays.
Purpose of the Study:
- To evaluate the impact of different patient care pathways on reperfusion times in STEMI.
- To compare the effectiveness of a direct emergency service chain versus a longer, indirect pathway.
- To identify factors contributing to delays in STEMI reperfusion.
Main Methods:
- Retrospective monocentric study of 838 STEMI patients over 4 years.
- Comparison of reperfusion times between patients using a 'Direct chain' and a 'Long chain' pathway.
- Analysis of patient flow from initial contact to reperfusion.
Main Results:
- 42.5% of STEMI patients utilized the Direct chain pathway.
- The Direct chain pathway resulted in a significantly shorter average reperfusion time (4.26 hours) compared to the Long chain (6.17 hours).
- A significant difference of 1.9 hours in reperfusion time was observed between the two groups (P<0.001).
Conclusions:
- The Direct chain pathway significantly reduces STEMI reperfusion times.
- Improved medical education and patient information are needed to optimize STEMI care pathways.
- Streamlining patient access to emergency cardiac care is crucial for better outcomes.
Introduction:
Acute coronary syndrome with ST segment elevation (STEMI) remains a major cause of morbidity and mortality in France, directly correlated with the time management of the patient to achieve reperfusion of the artery as early as possible. But the delay of reperfusion is related to the course that will take the patient to the revascularization.
Methods:
To make an observation of departmental practices, we conducted a retrospective monocentric study on the STEMI supported on 4years in the Departmental Hospital of La Roche-sur-Yon by comparing the time of reperfusion in two groups: patients who used the recommended chain=diRect chain (Call the emergency number-specialist mobile emergency unit-Cardiac intensive care unit or cardiac catheterization laboratory), and patients who used another chain=Long chain.
Results:
On 838 patients with STEMI, 356 (42.5%) used the Direct chain. The average time of reperfusion in the Direct chain group is 4.26hours (±3.12), 6.17hours (±4.82) in the Long chain group. There is a significant difference between the two groups of 1.9hours (P<0.001). Of 186 patients who consulted a general practitioner, 40.3% of patients were not supported by the mobile emergency unit.
Conclusion:
These results should lead to improved practices, to carry on continuing medical education with all actors in the chain and patient information to shorten up the time of reperfusion.
More Related Videos
05:26Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:26Acute Coronary Syndrome V: Nursing Management