ArticleEmergency medicine journal : EMJ2004
Emergency department thrombolysis improves door to needle times.
Article in Emergency medicine journal : EMJ, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
6 citing papers in PubMed.
- Effective Factors in Door-to-Needle Time for Streptokinase Administration in Patients With Acute Myocardial Infarction Admitted to the Emergency Department.Trauma monthly · 2016Article
- Failure to improve door-to-needle time by switching to emergency physician-initiated thrombolysis for ST elevation myocardial infarction.Postgraduate medical journal · 2013Article
- Reduction in Door-to-Needle Time after Transfer of Thrombolysis Site from CCU to Emergency Department.Emergency medicine international · 2013Article
- A review of interventions and system changes to improve time to reperfusion for ST-segment elevation myocardial infarction.Journal of general internal medicine · 2008Review
- A nation divided.Emergency medicine journal : EMJ · 2006Article
- Does initiation of an ambulance pre-alert call reduce the door to needle time in acute myocardial infarct?Emergency medicine journal : EMJ · 2006Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify the effect on door to needle (DTN) time of moving the site of thrombolysis delivery from the coronary care unit (CCU) to the emergency department (ED). To ascertain if moving the site of thrombolysis enables appropriate use of thrombolysis.
designProspective cohort study.
settingCCU and ED of a 450 bed Scottish district general hospital without on-site primary angioplasty.
participantsPrimary site for thrombolysis of patients presenting to the hospital with ST elevation MI (STEMI) moved from CCU to ED on 1 April 2000. Study patients who had a confirmed STEMI and/or received thrombolytic therapy before this date were defined as the pre-change group; those who were diagnosed as STEMI and/or received thrombolytic therapy after this date were defined as the post-change group. STATISTICAL ANALYSIS: Mann-Whitney test was used to compare medians and chi(2) test for categorical data.
results1349 patients were discharged from CCU with a diagnosis of STEMI or received thrombolysis in the ED or CCU between April 1998 and April 2002. There were 632 patients in the pre-change group and 654 patients in the post-change group. Sixty three patients were excluded. Median DTN time for the pre-change group (321 thrombolysed patients) was 64 minutes and median DTN time for the post-change group (324 thrombolysed patients) was 35 minutes, a median difference of 25 minutes (95% CI for difference 20 to 29 minutes, p<0.0001, Mann-Whitney U test). A total of 37 patients were thrombolysed but did not have a final diagnosis of STEMI.
conclusionA significant reduction in DTN times accompanied this change in practice in this hospital.
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