دورية أكاديمية
Impact of Chest Pain Protocol with Access to Telemedicine on Implementation of Pharmacoinvasive Strategy in a Private Hospital Network.
| العنوان: | Impact of Chest Pain Protocol with Access to Telemedicine on Implementation of Pharmacoinvasive Strategy in a Private Hospital Network. |
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| المؤلفون: | Macedo TA; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., de Barros E Silva PG; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., Simões SA; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., Okada MY; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., Garcia JC; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., Sampaio MC; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., Dantas RN Jr; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., Oliveira RP; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., Rocha LG; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., da Cunha Lopes BB; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., Frigini T; Emergency Department, Hospital TotalCor , São Paulo, Brazil ., Furlan V; Emergency Department, Hospital TotalCor , São Paulo, Brazil . |
| المصدر: | Telemedicine journal and e-health : the official journal of the American Telemedicine Association [Telemed J E Health] 2016 Jul; Vol. 22 (7), pp. 549-52. Date of Electronic Publication: 2015 Dec 22. |
| نوع المنشور: | Journal Article; Observational Study; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 100959949 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3669 (Electronic) Linking ISSN: 15305627 NLM ISO Abbreviation: Telemed J E Health Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., c2000- |
| مواضيع طبية MeSH: | Clinical Protocols/*standards , Hospitals, Private/*organization & administration , Information Dissemination/*methods , ST Elevation Myocardial Infarction/*therapy , Telemedicine/*organization & administration, Aged ; Brazil ; Female ; Hospital Mortality/trends ; Hospitals, Private/standards ; Humans ; Inservice Training ; Male ; Middle Aged ; Telemedicine/standards |
| مستخلص: | Background: 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. Materials and Methods: 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). Results: 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). Conclusions: 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. |
| فهرسة مساهمة: | Keywords: chest pain protocol; myocardial infarction; telemedicine |
| تواريخ الأحداث: | Date Created: 20151224 Date Completed: 20171120 Latest Revision: 20180213 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1089/tmj.2015.0178 |
| PMID: | 26693879 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1556-3669 |
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| DOI: | 10.1089/tmj.2015.0178 |