Standardised pre-hospital care of acute myocardial infarction patients: MISSION! guidelines applied in practice
| العنوان: | Standardised pre-hospital care of acute myocardial infarction patients: MISSION! guidelines applied in practice |
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| المؤلفون: | E E van der Wal, H J van Exel, Joop Jukema, M.J. Schalij, Eric P. Viergever, Douwe E. Atsma, R van den Dijk, Jan Bosch, M I Sedney, I Padmos, M de Visser, Marianne Bootsma, Su-San Liem, Charles J. H. J. Kirchhof, M L Antoni, Harriette F. Verwey, Jael Z. Atary |
| المساهمون: | Neurology |
| المصدر: | Netherlands heart journal, 18(9), 408-415. Bohn Stafleu van Loghum Netherlands Heart Journal, 18(9), 408-415 |
| سنة النشر: | 2010 |
| مصطلحات موضوعية: | medicine.medical_specialty, Troponin T, business.industry, health care facilities, manpower, and services, medicine.medical_treatment, Angioplasty Transluminal Percutaneous Coronary, Percutaneous coronary intervention, Time Factors coronary-heart-disease prevention guidelines american-college euroaspire-i risk-factors mortality management trends elevation countries, Guideline, medicine.disease, Hospital care, Prevention & Control, Myocardial Infarction/therapy, Interquartile range, Conventional PCI, Emergency medicine, medicine, Original Article, Myocardial infarction, Risk factor, Cardiology and Cardiovascular Medicine, Intensive care medicine, business, health care economics and organizations |
| الوصف: | Background. To improve acute myocardial infarction (AMI) care in the region 'Hollands-Midden' (the Netherlands), a standardised guideline-based care program was developed (MISSION!). This study aimed to evaluate the outcome of the pre-hospital part of the MISSION! program and to study potential differences in pre-hospital care between four areas of residency. Methods. Time-to-treatment delays, AMI risk profile, cardiac enzymes, hospital stay, in-hospital mortality, and pre-AMT medication was evaluated in consecutive AMI patients (n=863, 61 +/- 13years, 75% male) transferred to the Leiden University Medical Center for primary percutaneous coronary intervention (PCI). Results. Median time interval between onset of symptoms and arrival at the catheterisation laboratory was 150 (interquartile range [IQR] 101-280) minutes. The alert of emergency services to arrival at the hospital time was 48 (IQR 40-60) minutes and the door-to-catheterisation laboratory time was 23 (IQR 13-42) minutes. Despite significant regional differences in ambulance transportation times no difference in total time from onset of symptoms to arrival at the catheterisation room was found. Peak troponin T was 3.33 (IQR 1.23-7.04) mu g/l, hospital stay was 2 (IQR 2-3) days and in-hospital mortality was 2.3%. Twelve percent had 0 known risk factors, 30% had one risk factor, 45% two to three risk factors and 13% had four or more risk factors. No significant differences were observed for AMI risk profiles and medication pre-AMI. Conclusions. This study shows that a standardised regional AMI treatment protocol achieved optimal and uniformly distributed pre-hospital performance in the region 'Hollands-Midden', resulting in minimal time delays regardless of area of residence. Hospital stay was short and in-hospital mortality low. Of the patients, 88% had >= 1 modifiable risk factor. (Neth Heart J 2010;18:408-15.) |
| اللغة: | English |
| تدمد: | 1568-5888 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4c616dd2a4fbdde229b17e3ab996dfe9 https://doi.org/10.1007/bf03091807 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....4c616dd2a4fbdde229b17e3ab996dfe9 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 15685888 |
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