Time is Muscle

Abreu, Luiz Maurino

doi:10.5935/abc.20190059

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…To grasp time for treatment is important for some diseases to rescue damaged organs. For example, a concept of “time is muscle” was deliberated over by cardiologists regarding the treatment of primary percutaneous coronary intervention for acute ischemic heart disease, aiming to limit the extent of myocardial damage [ 25 , 26 ], meaning that severity and extent of myocardial ischemic injury resulting from coronary occlusion could be radically altered by timely intervention [ 26 ]. A similar thought of “time is limb” was also mentioned in acute limb ischemia needing early recognition of poor perfusion thereby requiring revascularization to prevent limb loss and life-threatening morbidity [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

The analysis for time of referral to a medical center among patients with diabetic foot infection

et al. 2021

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Background Diabetic foot infection (DFI) is a limb- and life-threatening complication for diabetic patients needing immediate and comprehensive treatment. Early referral of DFI patients to a diabetic foot center is recommended but there appears limited validated evidence, with the association between referral time and clinical outcomes of limb- preservation or in-hospital mortality still lacking. Methods This retrospective research studied consecutive type 2 diabetic patients with DFI treated at the major diabetic foot center in Taiwan from 2014 to 2017. Six hundred and sixty-eight patients presented with limb-threatening DFI. After stratifying their referral days into quartiles, the demographic information and clinical outcomes were analyzed. Results One hundred and seventy-two patients were placed in the first quartile (Q1) with less than 9 days of referral time; 164 in the second quartile (Q2) with 9-21 days; 167 in the third quartile (Q3) with 21-59 days; and 165 in the fourth quartile (Q4) with >59 days. End-stage renal disease (ESRD), major adverse cardiac events (MACE) and peripheral arterial disease (PAD) were noted as being higher in the Q4 group compared with the Q1 group (25.45% vs 20.35% in ESRD, 47.27% vs 26.16% in MACE and 78.79% vs 52.33% in PAD respectively). The Q1 group had more patients presenting with systemic inflammatory responsive syndrome (SIRS) (29.07% in Q1 vs 25.45% in Q4 respectively, P=0.019). Regarding poor outcome (major lower-extremity amputation (LEA) or in-hospital mortality), the Q4 group had 21.21% of patients in this category and the Q1 group had 10.47%. The odds ratio of each increased referral day on poor prognosis was 1.006 with 95% confidence interval 1.003–1.010 (P=<0.001). In subgroups, the impact on poor prognosis by day was most obvious in patients with SIRS (OR 1.011, 95% CI 1.004–1.018, P=0.003) and those with PAD (OR 1.004, 95% CI 1.001–1.008, P=0.028). Conclusions The deferred referral of DFI patients to the diabetic foot center might be associated with poor treatment outcome either in major LEA or mortality, particularly in patients with SIRS or PAD. Both physician and patient awareness of disease severity and overcoming the referral barrier is suggested. Trial registration Not applicable.

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Section: Discussionmentioning

confidence: 99%

The analysis for time of referral to a medical center among patients with diabetic foot infection

et al. 2021

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“… [1] After the findings of thrombus as a culprit in coronary artery by Dewood et al, strategies of reperfusion changes from contemplation to intervention. [2] Even after the proven superiority of PCI compared to fibrinolysis, the selection and implementation of reperfusion strategy in real world remained worthy of discussion. [3] , [4] Numerous clinical trials have demonstrated that early presentation and shorten door to balloon time was associated with decreased mortality.…”

Section: Introductionmentioning

confidence: 99%

Statistical findings and outcomes of acute coronary syndrome patients during COVID-19 pandemic: A cross sectional study

Sanjaya¹,

Pramudyo²,

Achmad³

2023

IJC Heart & Vasculature

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“…Delay in the management of these results in adverse clinical outcomes is commonly emphasised by “Time is Muscle” in acute myocardial infarction and “Time is brain” in acute stroke. [ 3 , 4 ] In patients with meningitis, delay in antibiotic initiation (door-to-antibiotic time) is associated with increased mortality and unfavourable outcome at discharge. [ 5 ] In patients with sepsis, each 1 hour delay in the initiation of antibiotics is associated with a 10% increase in the 1 year mortality risk.…”

Section: Introductionmentioning

confidence: 99%

Clinical Inertia: A Wider Perspective and Proposed Classification Criteria

Raveendran

2023

Indian Journal of Endocrinology and Metabolism

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Clinical inertia is very common in day-to-day practice, and the factors contributing to that can be physician-related, patient-related, or health-care-related. Clinical inertia is commonly described in chronic asymptomatic illness. We searched the PubMed and Scopus databases for original articles and reviews. Based on the search result, in this review article, we redefine various terminologies to avoid confusion and propose classification criteria for the early identification of clinical inertia. Clinical inertia is also present in acute illness and in symptomatic disease. Early identification of clinical inertia is difficult because of very vague terminologies which have been used interchangeably as well as because of the lack of definitive classification criteria. In this article, we redefine clinical inertia and propose criteria for early identification, which will be useful for both clinicians and academicians. This review will help clinicians to identify and rectify various aspects of clinical inertia.

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Time is Muscle

Cited by 4 publications

References 13 publications

The analysis for time of referral to a medical center among patients with diabetic foot infection

The analysis for time of referral to a medical center among patients with diabetic foot infection

Statistical findings and outcomes of acute coronary syndrome patients during COVID-19 pandemic: A cross sectional study

Clinical Inertia: A Wider Perspective and Proposed Classification Criteria

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