Immediate review of ECGs by an emergency physician significantly reduced median door-to-balloon times compared to computer interpretation (85 vs 113 minutes; P<0.001).
Cohort (n=340)
Does immediate physician ECG interpretation reduce door-to-balloon times in STEMI patients compared to computer-interpreted ECGs?
Immediate physician interpretation of ECGs in STEMI patients significantly reduces door-to-balloon times compared to relying on computer interpretation.
Tasa de eventos absoluta: 85% vs 113%
valor p: p=<0.001
OBJECTIVE: The purpose of the project was to study the impact that immediate physician electrocardiogram (ECG) interpretation would have on door-to-balloon times in ST-elevation myocardial infarction (STEMI) as compared with computer-interpreted ECGs. METHODS: This was a retrospective cohort study of 340 consecutive patients from September 2003 to December 2009 with STEMI who underwent emergent cardiac catheterization and percutaneous coronary intervention. Patients were stratified into 2 groups based on the computer-interpreted ECG interpretation: those with acute myocardial infarction identified by the computer interpretation and those not identified as acute myocardial infarction. Patients (n = 173) from September 2003 to June 2006 had their initial ECG reviewed by the triage nurse, while patients from July 2006 to December 2009 (n = 167) had their ECG reviewed by the emergency department physician within 10 minutes. Times for catheterization laboratory activation and percutaneous coronary intervention were recorded in all patients. RESULTS: Of the 340 patients with confirmed STEMI, 102 (30%) patients were not identified by computer interpretation. Comparing the prior protocol of computer ECG to physician interpretation, the latter resulted in significant improvements in median catheterization laboratory activation time 19 minutes interquartile range (IQR): 10-37 vs. 16 minutes IQR: 8-29; P < 0. 029 and in median door-to-balloon time 113 minutes (IQR: 86-143) vs. 85 minutes (IQR: 62-106) ; P < 0. 001. CONCLUSION: The computer-interpreted ECG failed to identify a significant number of patients with STEMI. The immediate review of ECGs by an emergency physician led to faster activation of the catheterization laboratory, and door-to-balloon times in patients with STEMI.
Mawri et al. (Sat,) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=340). Immediate review of ECGs by an emergency department physician vs. Initial ECG reviewed by triage nurse (computer-interpreted ECG) was evaluated on Median door-to-balloon time (p=<0.001). Immediate review of ECGs by an emergency physician significantly reduced median door-to-balloon times compared to computer interpretation (85 vs 113 minutes; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: