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https://hdl.handle.net/11499/6226
Title: | Impact of a well-organized collaborative team approach on mortality in patients with ST-segment elevation myocardial infarction | Authors: | Yaylalı, Yalın Tolga Susam, İbrahim Ateş, Akın Dursunoglu, Dursun |
Keywords: | Mortality ST-segment elevation myocardial infarction Well-organized collaborative team approach acetylsalicylic acid angiotensin receptor antagonist beta adrenergic receptor blocking agent clopidogrel dipeptidyl carboxypeptidase inhibitor hydroxymethylglutaryl coenzyme A reductase inhibitor streptokinase tissue plasminogen activator acute heart infarction adult aged article cardiologist controlled study electrocardiogram female health care organization health care quality hospital service human major clinical study male mortality outcome assessment outpatient care patient care prospective study retrospective study ST segment elevation myocardial infarction survival rate therapy effect Adult Aged Bundle-Branch Block Cooperative Behavior Disease Management Female Fibrinolytic Agents Humans Male Middle Aged Myocardial Infarction Myocardial Reperfusion Patient Care Team Statistics, Nonparametric Thrombolytic Therapy Treatment Outcome |
Abstract: | Objective: Fibrinolytic therapy remains a legitimate option for many patients presenting with acute ST-segment elevation myocardial infarction (STEMI). Shorter time- to- treatment for patients with STEMI administered fibrinolytic therapy has repeatedly been shown to reduce mortality. A well-organized collaborative team approach was implemented in April 2007. The purpose of this study was to examine the effect of implementing a well-organized collaborative team approach on the outcome in patients with acute STEMI treated with fibrinolysis. Methods: Sociodemographic, clinical, laboratory, and time interval data were prospectively collected on 109 consecutive patients (the study group) and 155 patients from the years 2005-2007 (the control group) retrospectively. A single-phone call was made to discuss case. Emergency department evaluation was bypassed for definitive case. An electrocardiogram was faxed to the on-call cardiologist for suspected case. Doorto-needle times were calculated as medians. Mortality was assessed by reviewing records of all patients visiting outpatient clinic. For the rest, information was obtained over the phone. Median door-to-needle times were compared using Mann-Whitney U test. The Fisher's exact test was used to compare 6-month mortalities. Results: Improvements were seen in door-to- needle times in the study group regardless of time of presentation (reduced from 59 minutes to 29 minutes during off hours) (reduced from 35 minutes to 18 minutes during regular hours) (p<0.0001). Mortality was significantly reduced in the study group (2 deaths, 1.8%) compared with the control group (12 deaths, 7.7%, p=0.048). Conclusion: The mortality of patients presenting with acute STEMI treated with fibrinolytic therapy was significantly reduced after optimal hospital organization. © 2010 by AVES Yayi{dotless}nci{dotless}li{dotless}k Ltd. | URI: | https://hdl.handle.net/11499/6226 https://doi.org/10.5152/akd.2010.167 |
ISSN: | 1302-8723 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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