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Impact of capacity building and tele ECG based decision support on change in thrombolysis rate and inhospital and one year mortality in patients with STEMI, using hub and spoke model; multi-phasic intervention trial.
Negi, Prakash Chand; Dsouza, Savio; Kandoria, Arvind; Nijhavan, Rahul; Thakur, Pryanka; Thakur, Meena; Sharma, Meenakshi; Asotra, Sanjeev; Ganju, Neeraj; Marwah, Rajive; Sharma, Rajesh.
Afiliación
  • Negi PC; Indira Gandhi Medical College, Shimla, India. Electronic address: negiprakash59@gmail.com.
  • Dsouza S; Indira Gandhi Medical College, Shimla, India.
  • Kandoria A; Indira Gandhi Medical College, Shimla, India.
  • Nijhavan R; G B Panth Hospital Delhi, India.
  • Thakur P; Meditrina Hospital Ambala Cantt. haryana, India.
  • Thakur M; Indira Gandhi Medical College, Shimla, India.
  • Sharma M; Indian Council of Medical Research New Delhi, India.
  • Asotra S; Indira Gandhi Medical College, Shimla, India.
  • Ganju N; Indira Gandhi Medical College, Shimla, India.
  • Marwah R; Indira Gandhi Medical College, Shimla, India.
  • Sharma R; Indira Gandhi Medical College, Shimla, India.
Indian Heart J ; 76(3): 167-171, 2024.
Article en En | MEDLINE | ID: mdl-38885880
ABSTRACT

BACKGROUND:

We report the impact of capacity building and teleconsultation on change in the thrombolysis rates and one-year mortality in patients with STEMI using a hub and the spoke model of STEMI care.

METHODS:

Twenty secondary care public hospitals were linked with a teaching hospital as a hub centre and the impact of the intervention on change in ischemic time, thrombolysis rates and all-cause in-hospital and one-year mortality was compared.

RESULTS:

29 patients with STEMI were treated during pre-intervention from April 2020 to June 2020 and 255 patients during the post-intervention period from July 2020 to Oct 2021 in spoke centres. 245 patients were reported to a hub centre during the study period. The thrombolysis rate was significantly higher in the spoke centres after intervention (65.5%vs. 27.5 % p < 0.001) and was also significantly higher than in patients treated in a hub centre (65.5 % vs. 45.7 % p < 0.01). The in-hospital mortality was significantly lower in patients treated at spoke centres compared to those treated at the hub centre (7.8 % vs. 15.5 % < 0.003). The significant difference in mortality rate continued at one year (11.0 % vs.18.4 % p < 0.01). The median time from symptoms to thrombolytic therapy was significantly lower in STEMI patients treated in spoke centres compared to a hub centre (230 min vs. 356 min p < 0.001).

CONCLUSION:

The hub and spoke model of STEMI care is effective in increasing thrombolysis rate, and decreasing in-hospital and one-year mortality rate.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia Trombolítica / Mortalidad Hospitalaria / Electrocardiografía / Creación de Capacidad / Infarto del Miocardio con Elevación del ST Límite: Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Indian Heart J Año: 2024 Tipo del documento: Article Pais de publicación: India
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia Trombolítica / Mortalidad Hospitalaria / Electrocardiografía / Creación de Capacidad / Infarto del Miocardio con Elevación del ST Límite: Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Indian Heart J Año: 2024 Tipo del documento: Article Pais de publicación: India