Avtor/Urednik		Gorjup, Vojka
Naslov		Predbolnišnično zdravljenje bolnikov z akutnim srčnim infarktom z dvignjeno veznico ST
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Medicinska fakulteta
Leto izdaje		2004
Obseg		str. 33
Jezik		slo
Abstrakt		We compared prehospital treatment in 330 consecutive patients with ST-elevation acute myocardial infarction (STEMI) admitted to University Medical Center Ljubljana between July 1, 2002 and June 30, 2003 for primary percutaneous coronary intervention (PCI). Group A (n = 216) consisted of patients from Ljubljana region admitted to our emergency department. In group B (n = 85), there were patients transferred from regiona) non-PCI hospitals and in group C (n = 29) patients admitted directly from general outpatient clinics or from the field outside Ljubljana. »MONA« on the field was best implemented in group C. Emergency transport was correctly performed in 6% of patients in group A and in all patients in groups B and C. Patient time delay ranged between 85 and 110 minutes and was comparable in all three groups. Time delay from the first patient contact with prehospital emergency system to first balloon inflation was the shortest in group C (100 minutes), and longer in groups A (130 minutes) and B (190 minutes) (p < 0.05). Primary PCI was performed in 93% of patients. Normal epicardial blood flow in culprit coronary artery was restored in 93%. In-hospital MACE was 8.9% in group A, 13.4% in group B and 3.0% in group C (p = 0.18). MACE was increased from 7% to 16% if »door - to - balloon« exceeded 120 minutes (p < 0.001). Accordingly, patients referred to primary PCI directly from the general outpatient clinics or from the field receive most optimal prehospital treatment and transport, and have the shortest delay from entry into prehospital emergency system to primary PCI.
Deskriptorji		MYOCARDIAL INFARCTION EMERGENCY MEDICAL SERVICES ELECTROCARDIOGRAPHY ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY TRANSPORTATION OF PATIENTS TIME FACTORS TREATMENT OUTCOME