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- Berglin Blohm, Marianne, et al.
(författare)
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A media campaign aiming at reducing delay times and increasing the use of ambulance in AMI.
- 1994
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Ingår i: The American journal of emergency medicine. - : W.B. Saunders Co.. - 0735-6757 .- 1532-8171. ; 12:3, s. 315-8
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Tidskriftsartikel (refereegranskat)abstract
- To improve the prognosis in patients with acute myocardial infarction (AMI) if treatment by early instituting treatment, we initiated a media campaign during 1 year with the intention to reduce delay times and increase ambulance use in patients with acute chest pain. This article describes the outcome during 3 years after the campaign was finished. The median delay time in patients with AMI was reduced from 3 hours 0 min before the campaign to 2 hours 20 minutes during the year of the campaign (P < .001). The median delay time remained at a similar level (2 hours 20 min) during the 3 years after the campaign. Ambulance use was not affected during or after the campaign. It can be concluded that a media campaign resulted in a reduction of delay times not only during the campaign, but also during 3 years after its performance, whereas ambulance use was not affected.
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| 6. |
- Herlitz, Johan, 1949, et al.
(författare)
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The cost-benefit balance of coronary artery bypass grafting: need for hospitalization during the two years before and the two years after.
- 1996
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Ingår i: The Thoracic and cardiovascular surgeon. - : Georg Thieme Verlag KG. - 0171-6425 .- 1439-1902. ; 44:5, s. 239-44
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Tidskriftsartikel (refereegranskat)abstract
- To derive and compare the need for hospitalization during 2 years prior to coronary artery bypass grafting (CABG) and 2 years after, all the patients from western Sweden in whom CABG without simultaneous valve surgery was performed between June 1988 and June 1991 were evaluated. Hospitalization prior to and after surgery was derived via questionnaires sent to the patients and via data from their hospital medical record forms. In all, 2099 patients were studied. The mean total number of days in hospital was 16 during the 2 years before and 24 including surgery and postoperative complications during the 2 years after the operation (p < 0.001). When the days for operation and postoperative complications were excluded, the mean number of days after operation was 7 (p < 0.001). Hospitalization due to myocardial infarction, angina pectoris, percutaneous transluminal coronary angioplasty and other investigations for heart disease were significantly reduced after CABG. On the other hand, hospitalization due to chest pain with causes other than ischemic heart disease, congestive heart failure, arrhythmias, and reoperation was more frequent during the 2 years after surgery. The total number of days in hospital was higher during the 2 years after CABG than during the 2 years before, despite the fact that hospitalization due to ischemic events was significantly reduced after the operation.
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| 7. |
- Berglin Blohm, Marianne, et al.
(författare)
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The possibility of influencing components of hospital delay time within emergency departments among patients with ST-elevation in the initial electrocardiogram.
- 1998
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Ingår i: European journal of emergency medicine : official journal of the European Society for Emergency Medicine. - : Lippincott Williams & Wilkins, Ltd.. - 0969-9546 .- 1473-5695. ; 5:3, s. 289-96
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the possibility of influencing components of hospital delay time within the emergency department (ED) among patients with ST-elevation on the initial electrocardiogram (ECG). Nurses recorded seven patient time points: (1) ED admission; (2) ECG recording; (3) decision by nurse/ED physician; (4) cardiologist ED arrival; (5) decision of coronary care unit (CCU) admission; (6) ED departure; (7) CCU arrival. After special training in ECG, nurses in the ED were subsequently delegated to send patients directly to the CCU if showing ST-elevation on the admission ECG without contacting either the physician in ED or the cardiologist on call (intervention). Delay times between hospital admission and admission to the CCU were evaluated during the 9 months prior to and during the 6 months after the start of this intervention. Fifty patients (66% men) participated in the first study during 3 months (prior to intervention). Patients with suspected or confirmed acute myocardial infarction (AMI) in the ED had a median delay time from ED arrival to CCU arrival of 55.5 minutes (34.5 minutes for patients with confirmed AMI; ST elevation on admission). Time interval from decision to admit to CCU and ED departure was an average of 31% of the total delay. A mean of 21% of total delay occurred between ED decision to cardiologist arrival, and 19% during the time interval from cardiologist ED arrival until decision to CCU admission. Among patients receiving thrombolysis, the median delay time from hospital admission to CCU admission was reduced from 40 minutes during the 9 months prior to start of the intervention (nurses sending patients directly to the CCU) to 22 minutes during the 6 months thereafter (p = 0.02). The largest proportion of hospital delay components for acute coronary syndrome patients occurred between the cardiologist's decision to admit to the CCU and departure from the ED, and the interval following the decision by the nurse or physician to the cardiologist ED arrival. When nurses were delegated to transfer patients with ST-elevation on admission directly to the CCU without contacting a physician, the delay time from ED admission to CCU admission was reduced by nearly 50%.
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| 9. |
- Bräutigam, Malin, et al.
(författare)
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[Primary PTCA or thrombolysis in acute myocardial infarction?]. : Primär PTCA eller trombolys vid akut hjärtinfarkt?
- 2001
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Ingår i: Läkartidningen. - 0023-7205. ; 98:32-33, s. 3392-5
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Tidskriftsartikel (refereegranskat)abstract
- In acute ST-elevation infarction two different reperfusion strategies--thrombolytic medication and acute coronary angiography--have proved to improve the prognosis. The clinical course for patients with ST-elevation infarction is described in relation to whether they received thrombolytic medication or underwent acute coronary angiography with the aim of mechanical revascularization. The one-year mortality was high (20 percent) regardless of treatment strategy. In terms of morbidity there were no clear differences between the two treatment groups.
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| 10. |
- Bång, Angela, et al.
(författare)
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Lower mortality after prehospital recognition and treatment followed by fast tracking to coronary care compared with admittance via emergency department in patients with ST-elevation myocardial infarction.
- 2008
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Ingår i: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 129:3, s. 325-332
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe the short-and long-term outcome among patients with an ST-elevation myocardial infarction (STEMI), assessed and treated by the emergency medical services (EMS) in relation to whether they were fast tracked to a coronary care unit (CCU) or admitted via the emergency department (ED). METHODS: Consecutive patients admitted to the CCU at Sahlgrenska University Hospital with ST elevations on admission ECG were analysed with respect to whether they by the EMS were fast tracked to the CCU or the adjacent coronary angiography laboratory (direct CCU group; n=261) or admitted via the ED (ED group; n=235). RESULTS: Whereas the two groups were similar with regard to age and previous history, those who were fast tracked to CCU were more frequently than the ED patients diagnosed and treated as STEMI already prior to hospital admission. Reperfusion therapy was more commonly applied in the CCU group compared with the ED group (90% vs 67%; <0.0001). The delay times (median) were shorter in the direct CCU group than in the ED group, with a difference of 10 min from the onset of symptoms to arrival in hospital and 25 min from hospital arrival to the start of reperfusion treatment (primary PCI or in-hospital fibrinolysis). Patients in the direct CCU group had lower 30-day mortality (7.3% vs. 15.3%; p=0.004), as well as late mortality (>30 days to five years) (11.6% vs. 20.6%; p=0.008). CONCLUSION: Among patients transported with ambulance due to STEMI there was a significant association between early recognition and treatment followed by fast tracking to the CCU and long term survival. A higher rate of and a more rapid revascularisation were probably of significant importance for the outcome.
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