Izvorni znanstveni članak
Baseline characteristics, time-to-hospital admission and in-hospital outcomes of patients hospitalized with ST-segment elevation acute coronary syndromes, 2002 to 2005
Zlatko Pehnec
; University Hospital Maribor, Department of Internal Medicine, Ljubljanska 5, 2000 Maribor, Slovenia
Andreja Sinkovič
; University Hospital Maribor, Department of Internal Medicine, Ljubljanska 5, 2000 Maribor, Slovenia
Borut Kamenik
; University Hospital Maribor, Department of Internal Medicine, Ljubljanska 5, 2000 Maribor, Slovenia
Martin Marinšek
; University Hospital Maribor, Department of Internal Medicine, Ljubljanska 5, 2000 Maribor, Slovenia
Franci Svenšek
; University Hospital Maribor, Department of Internal Medicine, Ljubljanska 5, 2000 Maribor, Slovenia
Sažetak
Objective. The purpose of this study was to retrospectively determine baseline patient characteristics, time-to-hospital admission, utilization of reperfusion therapy and outcomes of patients hospitalized with ST-segment elevation acute coronary syndromes (ACS) between 2002 and 2005, particularly after 24-h primary percutaneous coronary intervention (PCI) was introduced in 2004.
Methods. Included were all patients admitted to the intensive care unit (ICU) from 2002 to 2005 who met the criteria for ACS. Information on patients' demographic characteristics, medical history, time-to-hospital admission, clinical characteristics on admission, laboratory examinations, ECG findings, treatments, hospital duration, and in-hospital outcomes was collected by completing a standardized case report form.
Results. There was a sustained increase in admissions between 2002 and 2005, altogether 899 patients were hospitalized. A significant decrease in time-to-hospital admission was achieved. More patients arrived within 4-6 hours (16.3% in 2002 vs. 31.5% in 2005) and less after 12 hours (35.0% in 2002 vs. 13.4% in 2005). A significant increase in primary PCI rate was achieved (16.9% in 2002 vs. 90% in 2005, P<0.001). Consequently, the rate of thrombolysis, postponed PCI and nonreperfusion medical therapy decreased. From 2002 to 2005, total in-hospital stay decreased significantly (15.4±13.0 days vs. 7.8±8.5 days, P<0.001), in-hospital mortality insignificantly (11.3% vs. 7.2%).
Conclusion. Despite the significant increase in primary PCI between 2002-2005, there was only an insignificant decrease in in-hospital mortality. Further shortening the time-to-hospital admission and increasing primary PCI among older hemodynamically unstable ACS patients, particularly those with cardiogenic shock, could achieve an additional decrease in mortality.
Ključne riječi
acute coronary syndrome; acute myocardial infarction; time-to-hospital admission; prognosis; management; percutaneous coronary intervention; mortality
Hrčak ID:
36032
URI
Datum izdavanja:
1.4.2009.
Posjeta: 1.420 *