December 7, 2010European Heart Journal
Urban and rural implementation of pre-hospital diagnosis and direct referral for primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction
Key result
Pre-hospital diagnosis and direct referral for primary PCI significantly reduced system delay compared to no pre-hospital diagnosis (92 vs. 153 min, P<0.001).
Why the study?
Does pre-hospital ECG diagnosis and direct referral reduce system delay for primary PCI in patients with STEMI?
Population
759 consecutive patients with acute ST-elevation myocardial infarction from a large geographical area…
Comparison
Pre-hospital electrocardiographic diagnosis and… vs No pre-hospital diagnosis
Design
Cohort
Authors
Discussion
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Member takes
Implication
Supports pre-hospital ECG diagnosis to shorten STEMI system delays; leaves open outcome benefits in randomized trials.
Study Design
Type
Cohort (n=759)
Multicenter
Yes
Structured PICO
Does pre-hospital ECG diagnosis and direct referral reduce system delay for primary PCI in patients with STEMI?
P
Population
759 consecutive patients with acute ST-elevation myocardial infarction (STEMI) from a large geographical area comprising both urban and rural districts
I
Intervention
Pre-hospital electrocardiographic (ECG) diagnosis and direct referral to a primary percutaneous coronary intervention (PCI) centre
C
Comparator
No pre-hospital diagnosis
O
Outcome
Time from emergency medical services contact to balloon inflation (system delay)
Main Result
Absolute Event Rate: 92% vs 153%
p-value: p=<0.001
Pre-hospital ECG diagnosis and direct referral significantly reduces system delay for primary PCI in STEMI patients, mitigating the impact of longer transport distances for rural patients.
Cite This Study
Sørensen et al. (2010) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=759). Pre-hospital diagnosis and direct referral for primary PCI vs. No pre-hospital diagnosis was evaluated on Time from emergency medical services contact to balloon inflation (system delay) (p=<0.001). Pre-hospital diagnosis and direct referral for primary PCI significantly reduced system delay compared to no pre-hospital diagnosis (92 vs. 153 min, P<0.001).