ArticleCureus2017
Does Frequency of ST-Segment Elevation Myocardial Infarction Presentation Impact Quality of Care?
Article in Cureus, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives The volume of ST-Segment Elevation Myocardial Infarctions (STEMIs) presenting to an emergency department (ED) has been shown to affect treatment quality measures and patient outcomes. Almost half of ST-elevation-myocardial-infarction (STEMI) patients in New Brunswick (NB) present directly to community hospitals. This study seeks to determine if the quality of care received by STEMI patients presenting to EDs in NB is related to the volume of STEMI presentations at that center. Methods This retrospective registry-based study used data from the STEMI database at the New Brunswick Heart Centre (NBHC), identifying 1196 cases of STEMI in NB, Canada, between December 2010 and April 2013. Patients were stratified into three groups based on the annual volume of STEMIs seen at the presenting center. Quality of care determinants, consisting of the percent of cases adhering to door-to-ECG (D2E), ECG-to-needle (E2N), and door-to-needle (D2N) time guidelines were then compared between groups. Results The mean age of the 1188 cases identified was 61.3 years, 73.8% were male, and 69.0% received thrombolysis. There was no difference in the rate of guideline adherence between the high, medium, and low-volume centers. The total rates of guideline adherence were 43.7%, 44.9%, and 47.5% for the D2E, E2N, and D2N times, respectively. Conclusion We did not identify any relationship between the rates of adherence with STEMI care guidelines and the volume of STEMI patients presenting to a center. Adherence rates were lower than in previously reported series from other regions. Further efforts should be undertaken to identify the causes of delayed STEMI diagnosis and treatment in our population and to implement system changes to improve standards of care.
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