In-Hospital ST Elevation Myocardial Infarction

Dai, Xuming; Garberich, Ross; Jaski, Brian E.; Smith, Sidney C.; Henry, Timothy D.

doi:10.1016/j.iccl.2016.06.005

Cited by 5 publications

(7 citation statements)

References 23 publications

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“…They are frequently admitted to non-cardiac services which are less accustomed to ECG acquisition, interpretation, and STEMI activation. 23 In-hospital mortality rates are much higher than that reported for conventional out-of-hospital STEMI. 24 Importantly, while care processes for out-of-hospital STEMI are commonplace, few systems which promote recognition, triage, and management of in-hospital STEMI exist leading to delays in diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 89%

Prognostic implications and outcomes of cardiac arrest among contemporary patients with STEMI treated with PCI

et al. 2021

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Background Cardiac arrest (CA) complicating ST-elevation myocardial infarction (STEMI) is associated with a disproportionately higher risk of mortality. We described the contemporary presentation, management, and outcomes of CA patients in the era of primary percutaneous coronary intervention (PCI). Methods We reviewed 1,272 consecutive STEMI patients who underwent PCI between 1/1/2011-12/31/2016 and compared characteristics and outcomes between non-CA (N = 1,124) and CA patients (N = 148), defined per NCDR definitions as pulseless arrest requiring cardiopulmonary resuscitation and/or defibrillation within 24-hr of PCI. Results Male gender, cerebrovascular disease, chronic kidney disease, in-hospital STEMI, left main or left anterior descending culprit vessel, and initial TIMI 0 or 1 flow were independent predictors for CA. CA patients had longer door-to-balloon-time (106 [83,139] vs. 97 [74,121] minutes, p = 0.003) and greater incidence of cardiogenic shock (48.0% vs. 5.9%, p < 0.001), major bleeding (25.0% vs. 9.4%, p < 0.001), and 30-day mortality (16.2% vs. 4.1%, p < 0.001). Risk score for 30-day mortality based on presenting characteristics provided excellent prognostic accuracy (area under the curve = 0.902). However, over long-term follow-up of 4.5 ± 2.4 years among hospital survivors, CA did not portend any additional mortality risk (HR: 1.01, 95% CI: 0.56–1.82, p = 0.97). Conclusions In a contemporary cohort of STEMI patients undergoing primary PCI, CA occurs in >10% of patients and is an important mechanism of mortality in patients with in-hospital STEMI. While CA is associated with adverse outcomes, it carries no additional risk of long-term mortality among survivors highlighting the need for strategies to improve the in-hospital care of STEMI patients with CA.

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Section: Discussionmentioning

confidence: 89%

Prognostic implications and outcomes of cardiac arrest among contemporary patients with STEMI treated with PCI

et al. 2021

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“…These factors contribute to frequent delays in recognition and triage of the patient with in-hospital STEMI. 18 Patients with in-hospital STEMI are much less likely to undergo diagnostic catheterization and PCI than those with out-of-hospital STEMI. 2,4,6,7,9 Only 34% to 71% of patients with in-hospital STEMI undergo diagnostic catheterization, and only 22% to 56% undergo PCI 2,6,7,9 (Figure 1).…”

Section: Treatment and Prognosismentioning

confidence: 99%

“…Three areas of delay that merit particular attention are (1) delays in ECG acquisition, (2) delays in ECG interpretation, and (3) delays in activation of existing STEMI systems of care. 18 Hence, 3 areas of emphasis to improve patient care include (1) hospitalwide low threshold to expeditiously obtain an ECG in those with hemodynamic decompensation or other signs that might suggest acute MI, (2) a process for immediate review and interpretation of the ECG, and (3) formal in-hospital STEMI activation process. The process of STEMI team or catheterization laboratory activation for an in-hospital STEMI should as much as possible mirror that for patients who present to the emergency department and are diagnosed as having STEMI.…”

Section: Improving Systems Of Care For In-hospital Stemimentioning

confidence: 99%

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In-Hospital ST-Segment Elevation Myocardial Infarction

et al. 2018

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“…Sabapathy and Bhardwaj studied on setting the goals in the management of mutilated injuries of the hand, impressions based on the ganga hospital experience[8].Dai et al. worked in the in-hospital st elevation myocardial ınfarction: clinical characteristics, management challenges, and outcome[19]. Koh worked on the management of work place bullying in hospital made a review of the use of cognitive rehearsal as an alternative management strategy[20].…”

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confidence: 99%

Selection of the Forecasting Model in Health Care

Kasapoälu¹

2016

J Hosp Med Manage

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Forecasting is one of the first steps in planning; the success of the plans depends on the accuracy of the forecasts. In the service industries like the hospitals, there are many plans that depend on the forecast, from capacity planning to aggregate planning, from layout decisions to the daily schedules. The accuracy of the forecasts could be determined by the error indicators after the trial of the many methods that fits our data.

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In-Hospital ST Elevation Myocardial Infarction

Cited by 5 publications

References 23 publications

Prognostic implications and outcomes of cardiac arrest among contemporary patients with STEMI treated with PCI

Prognostic implications and outcomes of cardiac arrest among contemporary patients with STEMI treated with PCI

In-Hospital ST-Segment Elevation Myocardial Infarction

Selection of the Forecasting Model in Health Care

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