Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Arq Bras Cardiol. 2013 Apr;100(4):307-14. Epub 2013 Apr 2.
The creation of an acute myocardial infarction (AMI) system of care aims to optimize the management of patients from early diagnosis to proper and timely treatment.
To assess the establishment of an AMI System of Care in the city of Belo Horizonte, state of Minas Gerais, and its impact on AMI in-hospital mortality.
The AMI system of care was established in the city of Belo Horizonte between 2010 and 2011, aiming at increasing the access of patients of the public health system to the treatment recommended by the existing guidelines. The teams at the emergency care units were trained, and the tele-electrocardiography system was implanted in those units. The primary outcomes of this retrospective observational study were the number of admissions and AMI in-hospital mortality, from 2009 to 2011.
During the study period, 294 professionals were trained and 563 electrocardiograms (ECGs) transmitted from emergency care units to coronary care units. A significant reduction was observed in the in-hospital mortality rate (12.3% in 2009 versus 7.1% in 2011, p < 0.001), while the number of admissions due to AMI remained stable. The mean cost of admission increased (mean R$ 2,480.00 versus R$ 3,501.00; p < 0.001), the proportion of admissions including intensive care unit stay increased (32.4% in 2009 versus 66.1% in 2011; p < 0.001), and the number of patients admitted to tertiary hospitals increased (47.0% versus 69.6%; p < 0.001).
The establishment of the AMI system of care improved the access of the population to proper treatment, thus reducing AMI in-hospital mortality. [corrected].
创建急性心肌梗死（AMI）治疗体系旨在优化患者从早期诊断到适当和及时治疗的管理。
评估米纳斯吉拉斯州贝洛奥里藏特市 AMI 治疗体系的建立及其对 AMI 院内死亡率的影响。
AMI 治疗体系于 2010 年至 2011 年在贝洛奥里藏特市建立，旨在增加公共卫生系统患者获得现有指南推荐治疗的机会。培训了急救单元的团队，并在这些单元中植入了远程心电图系统。这项回顾性观察研究的主要结果是 2009 年至 2011 年的住院人数和 AMI 院内死亡率。
在研究期间，培训了 294 名专业人员，并从急救单元向冠心病监护单元传输了 563 份心电图。观察到院内死亡率显著降低（2009 年为 12.3%，2011 年为 7.1%，p < 0.001），而因 AMI 住院的人数保持稳定。入院平均费用增加（平均 R$2480.00 比 R$3501.00；p < 0.001），包括重症监护病房停留的入院比例增加（2009 年为 32.4%，2011 年为 66.1%；p < 0.001），以及转诊至三级医院的患者人数增加（47.0%比 69.6%；p < 0.001）。
AMI 治疗体系的建立改善了人群获得适当治疗的机会，从而降低了 AMI 院内死亡率。
