Evidence map›Paper›PMID 34406317›Full record

ArticleArquivos brasileiros de cardiologia2021

Training Non-Cardiologists Could Improve the Treatment Results of ST Elevation Myocardial Infarction.

Luiz Antonio Machado Cesar, Antonio Padua Mansur, Rui Fernando Ramos, Carlos Magalhães, João Fernando Monteiro Ferreira, Bruno Mahler Mioto, Naide Aparecida de Oliveira, Pedro Silvio Farsky, Amaury Zatorre Amaral, Antonio Célio Camargo Moreno

Erratum issuedAbstract read
In one paragraph

Article in Arquivos brasileiros de cardiologia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Luiz Antonio Machado CesarInCor - Instituto do Coração do Hospital das Clínicas da FMUSP, São Paulo, SP - Brasil.ORCID http://orcid.org/0000-0003-4436-1791
Antonio Padua MansurInCor - Instituto do Coração do Hospital das Clínicas da FMUSP, São Paulo, SP - Brasil.ORCID http://orcid.org/0000-0003-3051-1090
Rui Fernando RamosInstituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil.
Carlos MagalhãesUniversidade Nove de Julho, São Paulo, SP - Brasil.
João Fernando Monteiro FerreiraInCor - Instituto do Coração do Hospital das Clínicas da FMUSP, São Paulo, SP - Brasil.
Bruno Mahler MiotoInCor - Instituto do Coração do Hospital das Clínicas da FMUSP, São Paulo, SP - Brasil.
Naide Aparecida de OliveiraSecretaria da Saúde do Estado de São Paulo, São Paulo, SP - Brasil.
Pedro Silvio FarskySecretaria da Saúde do Estado de São Paulo, São Paulo, SP - Brasil.
Amaury Zatorre AmaralSecretaria Municipal da Saúde, São Paulo, SP - Brasil.
Antonio Célio Camargo MorenoSecretaria de Gestão Pública, São Paulo, SP - Brasil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccording to the World Health Organization, emerging countries will have an enormous growth in the number of heart attacks and related deaths. The main medical issue in Brazil is mortality caused by acute ST elevation myocardial infarction (STEMI). The Society of Cardiology in the State of São Paulo has never trained non-cardiologists as emergency personnel. Patients usually seek help from emergency departments instead of calling for an ambulance.

objectivesWe aimed at reducing in-hospital death rates from acute myocardial infarction by training emergency personnel in the city of Sao Paulo.

methodsWe used a training program for the personnel of five hospitals with >100 patients admitted with STEMI per year, and at least 15% in-hospital STEMI-associated mortality rate. We performed internet training, biannual-quarterly symposia for up to 400 participants, informative folders and handouts. Statistical analysis used the two proportion comparison test with p <0.05.

resultsNearly 200 physicians and 350 nurses attended at least one training from May 2010 to December 2013. Initially, many emergency physicians could not recognize an acute myocardial infarction on the electrocardiogram, but tele-electrocardiography is used in some emergency departments to determine the diagnosis. The death rate in the five hospitals decreased from 25.6%, in 2009, to 18.2%, in 2010 (p=0.005). After the entire period of training, the STEMI-associated death rate in all public hospitals of São Paulo decreased from 14.31%, in 2009, to 11.25%, in 2014 (p<0.0001).

conclusionEven simple training programs for emergency personnel can greatly reduce acute myocardial infarction death rates in undeveloped countries.

Indexed as

Emergency Medical ServicesMyocardial InfarctionST Elevation Myocardial InfarctionBrazilElectrocardiographyHospital MortalityHumans

Identifiers

PMID34406317
PMCPMC8757147

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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.