Evidence map›Paper›PMID 29739432›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2018

Emergency management of patients with ST-segment elevation myocardial infarction in Eastern Austria: a descriptive quality control study.

Helmut Trimmel, Thomas Bayer, Wolfgang Schreiber, Wolfgang G Voelckel, Lukas Fiedler

Open access · goldAbstract read
In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Electrocardiogram Interpretation Competency Among Paramedic Students.Journal of multidisciplinary healthcare · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Helmut TrimmelDepartment of Anesthesiology, Emergency and Critical Care Medicine, General Hospital Wiener Neustadt, Corvinusring 3-5, A 2700, Wiener Neustadt, Austria. Helmut.Trimmel@meduniwien.ac.at.ORCID http://orcid.org/0000-0002-7327-0699
Thomas BayerDepartment of Anesthesiology, Emergency and Critical Care Medicine, General Hospital Wiener Neustadt, Corvinusring 3-5, A 2700, Wiener Neustadt, Austria.
Wolfgang SchreiberMedical University Vienna, Vienna, Austria.
Wolfgang G VoelckelDepartment of Anesthesiology and Critical Care Medicine, AUVA Trauma Center Salzburg, Salzburg, Austria.
Lukas FiedlerDepartment of Internal Medicine II, General Hospital Wiener Neustadt, Wiener Neustadt, Austria.
Fachhochschule Wiener Neustadt · ATMedical University of Vienna · ATParacelsus Medical University · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMyocardial infarction is a time-critical condition and its outcome is determined by appropriate emergency care. Thus we assessed the efficacy of a supra-regional ST-segment elevation myocardial infarction (STEMI) network in Easternern Austria.

methodsThe Eastern Austrian STEMI network serves a population of approx. 766.000 inhabitants within a region of 4186 km

resultsA total of 416 STEMI cases were documented, and 99% were identified by EMS within 6 (4.0-8.0) minutes after arrival. Median time loss between onset of pain and EMS call was 54 (20-135) minutes; response, pre-hospital and door-to-balloon times were 14 (10-20), 46 (37-59) and 45 (32-66) minutes, respectively. When general practitioners were involved, time between onset of pain and balloon inflation significantly increased from 180 (135-254) to 218 (155-348) minutes (p < .001). A pre-hospital time < 30 min was achieved in 25.8% of all patients during the day vs. 11.6% during the night (p < .001). Three hundred forty-five patients (83%) were subjected to primary percutaneous coronary intervention (PPCI), and 6.5% were thrombolysed by EMS. Pre-hospital complication rate was 18% (witnessed cardiac arrest 7%, threatening arrhythmias 6%, cardiogenic shock 5%). Twenty-four hours and hospital mortality rate were 1.2 and 2.8%, respectively. DISCUSSION: Optimal patient care and subsequently outcome of STEMI is strongly determined by a short patient-decision time to call EMS and by the first medical contact to balloon time (FMCBT). Supra-regional networks are key in order to increase the efficacy and efficiency of health care. The goal of 120 min FMCBT was achieved in 78% of our patients immediately managed by EMS, thus indicating room for improvement.

conclusionIn conclusion, results from the Eastern Austrian STEMI network shed light on the necessity of increasing patient awareness in order to minimize any time loss derived by delayed EMS calls. Involvement of family physicians resulted in prolonged FMCBT. A stronger utilization of rescue helicopters could further improve the efficacy of this supra-regional network. Nevertheless PPCI rates, time intervals and outcome rates compare well with international benchmarks.

Indexed as

Emergency Medical ServicesAgedAged, 80 and overAustriaFemaleHospital MortalityHumansMaleMiddle AgedPercutaneous Coronary InterventionQuality ControlRetrospective StudiesST Elevation Myocardial InfarctionTime-to-TreatmentNetworkPre-hospital managementQuality control studyST-segment elevation myocardial infarctionTime intervals

Identifiers

PMID29739432
PMCPMC5941459
OpenAlexW2806670654

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.