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- W2078972523 abstract "This prospective study from Australia details outcomes in patients with ST-elevation myocardial infarction (STEMI) depending on triage mode. The modes include direct presentation to a hospital with catheterization facilities, direct presentation to community emergency departments (ED), and ambulance-based triage using transmission of 12-lead electrocardiograms (ECG) to the interventional facility. In the ambulance-based triage group, emergency physicians interpreted the transmitted ECG and when STEMI was identified, the ambulance was routed directly to the hospital with interventional capacity. Only angiographically confirmed STEMI patients were included in the analysis. Between April 2004 and June 2007, 524 patients had confirmed STEMI, and patients were followed-up by telephone at 30 days and at up to 2 years. Patients presenting directly to the interventional hospital tended to be older, with a mean age of 63 years, compared to 62 years for the prehospital group and 57 years for the community group. Use of the prehospital triage system resulted in a significant decrease in mean door-to balloon time (43 min) and mean symptom-to-reperfusion time (199 min) compared to direct presentation to interventional institution or community ED with means of 70 and 109 min, respectively. Left ventricular ejection fraction (LVEF) post STEMI was higher at 52% for the prehospital group compared to the interventional hospital (49%) and community groups (48%). Mortality at 30 days was 3% for the prehospital group, 11% for the interventional facility, and 4% for patients presenting directly to a community ED. Survival analysis revealed that these differences were realized within the first week and that long-term mortality did not differ between groups. Multivariate analysis revealed that predictors of mortality were age, previous ischemic heart disease, intubation before catheterization, symptom-to-perfusion time, and poor hemodynamic status. The authors conclude that prehospital triage and transmission of ECG is an effective strategy to reduce ischemia to perfusion time and thus improve LVEF and survival in patients with STEMI." @default.
- W2078972523 created "2016-06-24" @default.
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- W2078972523 date "2009-10-01" @default.
- W2078972523 modified "2023-09-27" @default.
- W2078972523 title "Effect of Prehospital Triage on Revascularization Times, Left Ventricular Function, and Survival in Patients with ST-Elevation Myocardial Infarction" @default.
- W2078972523 doi "https://doi.org/10.1016/j.jemermed.2009.06.113" @default.
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