Please use this identifier to cite or link to this item: 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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