Quality of Care for Patients With ST-Segment Elevation Myocardial Infarction Using Fast Track Service in Thailand
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Abstract
Background: The ST-segment elevation myocardial infarction (STEMI) fast track care recommend door to needle within 30 minutes. The current guideline is implemented in the community hospitals for timely reperfusion therapies, however, evaluation on its quality is limited.
Objective: To evaluate quality of care for patients with STEMI in community hospitals, Thailand.
Method: A descriptive design was conducted in three community hospitals, where distance from primary percutaneous coronary intervention (PCI)-capable hospital are more than 120 minutes. Consecutive sampling was used to select sample of patients with STEMI from October 1, 2016, to Mach 31, 2017. Data were collected from STEMI patients in 3 community hospitals using questionnaire and medical record reviews.
Results: Thirty-two STEMI patients participated in this study. The mean age of the patients was 62.5 ± 11.4 years. Most of them (87.5%) used self-transportation. Approximately 51.7% received streptokinase within time, while the average door to needle time was 48.4 minutes. The mean total ischemic time was 246.2 ± 365.7 minutes, and 18.8% of patients died in-hospital.
Conclusions: This study showed that door to needle time, door to balloon time, door to ECG, door to referral time, and total ischemic time were longer than recommended time. The main reasons were patients delay and system delay particular delayed diagnosis.
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References
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