Associazione Nazionale Medici Cardiologi Ospedalieri

CONGRESS ABSTRACT

CONGRESS ABSTRACT

OUT-OF-HOSPITAL MANAGEMENT INDICATORS IN THE APPLICATION OF THE UNIFIED PDTA “STEMI NETWORK” FOR THE AST OF ASCOLI PICENO AND FERMO: FROM DIAGNOSIS TO PCI WIRE-CROSSING. LONGITUDINAL OBSERVATIONAL CLINICAL STUDY

Paolone Luca Teramo(Teramo) РPubblica Assistenza | Parato Vito Maurizio San Bendetto del Tronto(Ascoli Piceno) РAST Ascoli Piceno | Traini Tiziana Ascoli Piceno(Ascoli Piceno) РUniversità Politecnica delle marche

IntroductionThe incidence of STEMI in European countries varies between 40 and 140/100 000/year, which equates to more than 500 000 patients with STEMI hospitalized each year. STEMI is defined by chest pain or equivalent symptoms and ST segment elevation or left bundle branch block on diagnostic ECG and subsequent confirmation of diagnosis by cardiac troponin elevation. The cornerstone of STEMI treatment is acute reperfusion therapy preferably with primary percutaneous coronary intervention (PPCI).Objective The general objective of the study proposes to detect the process and outcome indicators contained in the unified PDTA ‘STEMI Network’ of the AST of Ascoli Piceno and the AST of Fermo. The specific objective of the study is to aggregate in percentage form, the Items included in the data collection of patients diagnosed with ACS STEMI taken from the territory by emergency vehicles or arrived in the Emergency Room of the plants mentioned above with their own vehicle, in the 8 extra-hospital indicators provided for by the PDTA through.Materials and Methods All medical records diagnosed with SCA STEMI made available by U.T.I.C. have been selected of the HUB Hospital of Ascoli Piceno. All services provided for diagnosis of ACS N-STEMI have been excluded. The analysis period includes the last two months of 2022 and the first six months of 2023. A limitation emerged in identifying whether the rescue vehicle needed remote telephone consultation if the diagnosis had been doubtful in cases where the nursing staff did not use the intervention card provided by PDTA.Results and Conclusions Indicators: patients transferred to the HUB center and PCI 120 ‘ N 45 (85%) Ntot 53; Patients in Spoke and PCI 90 ‘ N6 (30%) Ntot 20; DIDO <30 ' N9 (45%) Ntot 20; ECG in Triage within 10 ' N29 (41%) Ntot 41; Pre-PCI drug treatment N89 (100%); Arrival PCI Hub 60 ' N13 (62%) Ntot 21; remote consultation N12 (23%) Ntot 53; favorable transmission ECG N31 (58%) Ntot 53. Other timing: FMC/WC ratio N89, average 110'. To reduce the timing target, increase the performance of the indicators according to the standards recommended, the only solution is the training of health personnel who works within the network and information to citizens for an early recognition of symptoms with a consequent first medical contact and the decision to subject the patient to a PCI-W.C. in the shortest possible time for a better long-term outcome term