Experience from a regional percutaneous coronary intervention center: Aiming to assess and improve quality of care

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Revista Portuguesa De Cardiologia Pub Date : 2024-10-01 DOI:10.1016/j.repc.2024.02.007

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引用次数: 0

Abstract

Introduction and Objectives

Ischemic heart disease is the single most common cause of death in Europe. Mortality in patients presenting with ST-elevation myocardial infarction (STEMI) is associated with many factors, one of which is the time delay to treatment. The purpose of this work is to analyze the coronary pathway in our region in terms of timing, taking into consideration the place of first medical contact (FMC).

Methods

Consecutive patients admitted to our center with STEMI to undergo percutaneous coronary intervention (PCI) between 2013 and 2022 were analyzed. Age, gender, and time delays were collected. Analysis was performed with IBM SPSS version 28 for a significance level of 0.05.

Results

We found that non-PCI centers had a significantly greater FMC to diagnosis delay and diagnosis to wire delay compared to other places of origin. Only 2.2% of patients met the 10-min FMC to diagnosis target; 44.8% met the target of 90 min from diagnosis to wire in transferred patients, while 40.6% met the 60-min target for patients admitted to a PCI center. Median patient, electrocardiogram (ECG) and logistic delays are 92.0±146.0 min, 19.0±146.0 min and 15.5±46.3 min, respectively.

Conclusion

A significant difference between state-of-the-art targets and reality was found, depending on the place of FMC, with the worst delays in non-PCI centers. Patient delay, ECG delay, FMC to diagnosis and logistic delay are identified as key areas in which to intervene.

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地区经皮冠状动脉介入治疗中心的经验：旨在评估和提高护理质量。

导言和目标缺血性心脏病是欧洲最常见的单一死因。ST段抬高型心肌梗死（STEMI）患者的死亡率与许多因素有关，其中之一就是治疗时间的延误。这项工作的目的是分析本地区冠状动脉路径的时间安排，同时考虑到首次医疗接触（FMC）的地点。方法对 2013 年至 2022 年期间本中心收治的 STEMI 患者进行经皮冠状动脉介入治疗（PCI）的连续患者进行分析。收集了患者的年龄、性别和延迟时间。结果我们发现，与其他来源地相比，非PCI中心的FMC到诊断延迟时间和诊断到导线延迟时间明显更长。只有 2.2% 的患者达到了从 FMC 到诊断的 10 分钟目标；44.8% 的转院患者达到了从诊断到接线 90 分钟的目标，而 40.6% 的 PCI 中心入院患者达到了 60 分钟的目标。患者、心电图（ECG）和逻辑延迟的中位数分别为（92.0±146.0）分钟、（19.0±146.0）分钟和（15.5±46.3）分钟。患者延迟、心电图延迟、FMC 到诊断以及物流延迟被认为是需要干预的关键领域。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Portuguesa De Cardiologia CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.70

自引率

22.20%

发文量

205

审稿时长

54 days

期刊介绍： The Portuguese Journal of Cardiology, the official journal of the Portuguese Society of Cardiology, was founded in 1982 with the aim of keeping Portuguese cardiologists informed through the publication of scientific articles on areas such as arrhythmology and electrophysiology, cardiovascular surgery, intensive care, coronary artery disease, cardiovascular imaging, hypertension, heart failure and cardiovascular prevention. The Journal is a monthly publication with high standards of quality in terms of scientific content and production. Since 1999 it has been published in English as well as Portuguese, which has widened its readership abroad. It is distributed to all members of the Portuguese Societies of Cardiology, Internal Medicine, Pneumology and Cardiothoracic Surgery, as well as to leading non-Portuguese cardiologists and to virtually all cardiology societies worldwide. It has been referred in Medline since 1987.