Ali Fatema Ahmed, Altahoo Hasan, Lynch Mary
Department of Medicine, College of Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen, Kingdom of Bahrain.
Department of Cardiology, Sh. Mohammed Bin Khalifa Cardiac Center, Bahrain Defence Force Royal Medical Services, Kingdom of Bahrain.
Heart Views. 2020 Oct-Dec;21(4):256-262. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_41_20. Epub 2021 Jan 14.
The aim was to assess the quality of practice provided to acute ST-elevation myocardial infarction (STEMI) patients at the cardiac center, within a specified time frame and identify possible areas of improvement.
This is a retrospective standards-based clinical review, including adults diagnosed with acute STEMI between January 1, 2016 and January 1, 2017 of cases admitted and managed at the respective cardiac center.
The study was designed according to recommendations provided by the National Institute for Health and Care Excellence guidelines: "The acute management of myocardial infarction with ST-segment elevation;" alongside, the local standard: door-to-balloon time ≤90 min, adopted from the American Heart Association.
Data analysis was done through excel and SPSS for advanced statistical calculations. < 0.05 was considered to be statically significant.
In total, 277 patients were included in the study. About 72% underwent primary percutaneous coronary intervention with 62 min as median door-to-balloon time. Door-to-balloon time >90 min was significantly higher when patients presented outside official hospital hours ( = 0.039). Transradial route was chosen in 77.7% of the cases.
Practice at the cardiac center was found to show good compliance with the guidelines. However, door-to-balloon time for procedures performed out of official hospital working hours was slightly outside the recommended limit.
旨在评估在特定时间范围内心脏中心为急性ST段抬高型心肌梗死（STEMI）患者提供的医疗服务质量，并确定可能需要改进的领域。
这是一项基于标准的回顾性临床审查，纳入了2016年1月1日至2017年1月1日期间在各心脏中心收治并接受治疗的确诊为急性STEMI的成年患者。
本研究是根据英国国家卫生与临床优化研究所指南“ST段抬高型心肌梗死的急性处理”以及美国心脏协会采用的当地标准“门球时间≤90分钟”的建议设计的。
通过Excel和SPSS进行数据分析以进行高级统计计算。P<0.05被认为具有统计学意义。
本研究共纳入277例患者。约72%的患者接受了直接经皮冠状动脉介入治疗，中位门球时间为62分钟。患者在医院非工作时间就诊时，门球时间>90分钟的比例显著更高（P=0.039）。77.7%的病例选择了经桡动脉途径。
发现心脏中心的医疗服务对指南的依从性良好。然而，在医院非工作时间进行手术的门球时间略超出推荐范围。
