International Journal of General Medicine (Sep 2020)
Effects of Prehospital Traige and Diagnosis of ST Segment Elevation Myocardial Infarction on Mortality Rate
Abstract
Reza Alizadeh,1 Ziba Aghsaeifard,2 Mostafa Sadeghi,3 Parisa Hassani,4 Peyman Saberian3 1Department of Anesthesiology and Intensive Care, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran; 2Department of Internal Medicine, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran,Iran; 3Department of Anesthesiology, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; 4School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IranCorrespondence: Peyman SaberianDepartment of Anesthesiology, Tehran University of Medical Sciences, Tehran, IranEmail [email protected]: Adverse outcomes and mortality associated with STEMI (ST segment elevation myocardial infarction) are associated with the management and diagnosis time. The aim of this study is to evaluate the outcomes of prehospital diagnosis of STEMI via emergency medical service (EMS) on mortality, in comparison to the patients who did not receive EMS.Methods: This retrospective study included STEMI patients, who underwent primary angioplasty. The patients were categorized as group A: referred without emergency service, group B: patients who did not receive PPCI and group C: patients referred via ambulance and received telecardiology. Medical records of these patients were evaluated for the diagnosis time, door-to-balloon time, in-hospital, six months, one year and three-year mortality, left ventricular ejection fraction and previous history of cardiovascular conditions and surgeries. The data were recorded and statistically analyzed using SPSS v21.Results: Of 424 patients studied, 79 were referred without emergency service (group A), 52 patients did not receive PPCI (group B) and 293 patients were referred via ambulance with telecardiology (group C). Door-to-balloon time was least in group C (57.78 min) compared to group A (141.70 min). In-hospital, six months, one year and three-year mortality was least in group C, however, the difference was not statistically significant. The left ventricular ejection fraction was significantly greater in group C.Conclusion: The results of our study indicate that prehospital diagnosis and telecardiology significantly reduce door-to-balloon time in STEMI patients referred for percutaneous intervention and might have an influence on short-term and long-term mortality rates.Keywords: prehospital, mortality rates, cardiology, myocardial infarction, STEMI
