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

Authors
  • Claúdio, Francisco Dias1
  • Carias, Miguel2
  • Almeida, António2
  • Paralta, Marta2
  • Viana, Rafael2
  • Serrano, Marisa3
  • Russo, Cláudia3
  • Mendes, Gustavo Sá2
  • Rocha, Rita2
  • Brás, Diogo2
  • Neves, David2
  • Bento, Ângela2
  • Fernandes, Renato2
  • Trinca, Manuel3
  • Patrício, Lino2
  • 1 Cardiology Department, Hospital Espírito Santo, Évora, Portugal; C-TRAIL - Alentejo Academic Clinic Center, Évora, Portugal. Electronic address: [email protected]. , (Portugal)
  • 2 Cardiology Department, Hospital Espírito Santo, Évora, Portugal; C-TRAIL - Alentejo Academic Clinic Center, Évora, Portugal. , (Portugal)
  • 3 Cardiology Department, Hospital Espírito Santo, Évora, Portugal. , (Portugal)
Type
Published Article
Journal
Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
Publication Date
Apr 23, 2024
Identifiers
DOI: 10.1016/j.repc.2024.02.007
PMID: 38663530
Source
Medline
Keywords
Language
Portuguese
License
Unknown

Abstract

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). 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. 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. 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. Copyright © 2024. Publicado por Elsevier España, S.L.U.

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