Door in - door out assessment of patients admitted with acute ST-segment elevation myocardial infarction in hospitals without catheterization facilities - 29/10/16
Résumé |
Background |
Many patients with acute ST-segment elevation myocardial infarction (STEMI) are admitted to emergency departments (EDs) of centres without percutaneous coronary intervention (PCI) facilities. The 2012 European Society of Cardiology guidelines recommend transfer to a PCI centre with a “door in - door out” (DI-DO) time≤30min.
Purpose |
To report DI-DO times in a registry of patients with acute STEMI.
Methods |
The RESeau des Urgences CORonarienne (RESUCOR) is a permanent registry of patients admitted with acute STEMI in 16 hospitals in the north French Alps since 2002. In patients admitted to a non-PCI centre, the DI-DO times were split into “diagnostic time” (from admission to transfer decision) and “logistical time” (from transfer decision to discharge).
Results |
Of 2081 patients included in the registry from 2012 to 2014, 493 were admitted directly into an ED (254 PCI centre and 239 non-PCI centre). Of those admitted into an ED of a non-PCI centre, 228 were immediately transferred to a PCI centre (76 treated with thrombolysis and 132 with primary PCI). The proportions of patients with DI-DO≤30min and median (interquartile range [IQR]) DI-DO times are reported in the Table 1. Median (IQR) DIDO times were 90.5 (69–118) min for patients treated with thrombolysis and 88 (62–147) min for primary PCI.
Conclusions |
DI-DO times were longer than recommended. Efforts to decrease these delays are required. Transfer with a non-PCI centre ambulance is preferable.
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Vol 65 - N° 5
P. 375 - novembre 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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