Türkiyede Primer Perkütan Koroner Girişim Yapılamayan Merkezlerde Akut ST-Segment Elevasyonlu Miyokart İnfarktüsünün Erken Tanısı Üzerine Akıllı Telefon Teknolojisinin Etkisi

Abstract

Giriş: Bu makalenin amacı akıllı telefon kullanılan dönemde çalışma ve çalışma dışı saatleri (ÇDS)’nde akut ST-elevasyonlu miyokart infarktüsü (STEMİ)’nün ortalama tanı süresini belirlemektir. Ayrıca uygulama varlığı ve yokluğunda ÇDS’deki tanı zamanları arasında önemli farklılık olup olmadığına bakılacaktır.

Hastalar ve Yöntem: Bu retrospektif çalışmaya Ocak 2013-Nisan 2014 tarihlerinde STEMİ tanısı konup primer perkütan koroner girişim (PKG) için transfer edilen 174 hasta alındı. Bu periyotta, hastanede ÇDS’de akıllı telefon kullanılmaktaydı. Ayrıca Ocak 2012-Kasım 2012 tarihlerinde ÇDS’de kardiyoloğun acile çağırılması veya hastane bilgisayarından kardiyoloğa elektronik posta ile elektrokardiyografi gönderilmesi yoluyla STEMİ tanısı konan 58 hasta alındı.

Bulgular: Uygulamanın kullanılmaya başlanılması sonrası çalışma sırasında hastaların tanı süresi ortalama 7.9 ± 1.7 dakikaydı. ÇDS’de STEMİ tanısı ortalama 8.2 ± 1.4 dakika olarak saptandı. Çalışma ve ÇDS arasında tanı zamanlarında fark görülmedi (p= 0.143). Uygulamanın kullanılmaya başlanması öncesi ÇDS’de STEMİ tanı süresi 18.0 ± 3.1 dakikaydı. ÇDS’de uygulama başlangıcı öncesi ve sonrası arasında STEMİ tanı süresi açısından anlamlı fark saptandı (p< 0.001).

Sonuç: Akıllı telefon uygulamalarının özellikle PKG yapılamayan merkezlerde ÇDS’de kullanılması STEMİ tedavisindeki gecikmeyi azaltarak kısa ve uzun dönem klinik sonuçlarda iyileşme sağlayabilir.

Keywords

• ST-elevasyonlu miyokart infarktüsü,elektrokardiyografi,akıllı telefon uygulaması,perkütan koroner girişim

Impact of Smartphone Technology on the Early Diagnosis of Acute ST-Segment Elevation Myocardial Infarction at Non-Primary Percutaneous Coronary Intervention Capable Centres in Turkey

Abstract

Introduction: This study aimed to determine the mean time for diagnosis of acute ST-segment elevation myocardial infarction (STEMI) for both working hours (WHs) and non-WHs (NWHs) during the period that a smartphone application was in use to aid the speed of diagnosis and any significant difference in diagnosis times during NWHs with and without use of the application.

Patients and Methods: In this retrospective study, 174 patients who had been diagnosed with STEMI and transferred for primary percutaneous coronary intervention between January 2013 and April 2014 were recruited. During this period, the hospital used a smartphone application to aid diagnosis during NWHs. In addition, 58 patients who were diagnosed with STEMI during NWHs between January 2012 and November 2012, either by a cardiologist called to the emergency department or an electrocardiography being sent to the cardiologist’s e-mail from a hospital computer, were enrolled.

Results: After the smartphone application was used, patients were diagnosed in a mean time of 7.9 ± 1.7 min during WHs, whereas STEMI was diagnosed in a mean time of 8.2 ± 1.4 min during NWHs. There was no statistically significant difference in diagnosis times between WHs and NWHs (p= 0.143). However, before the application was used, the mean time for the diagnosis of STEMI was 18.0 ± 3.1 min during NWHs, and consequently, there was a significant difference in STEMI diagnosis times during NWHs before and after the application began to be used (p< 0.001).

Conclusion: The application of smartphones, especially during NWHs at non-percutaneous coronary intervention-capable centres, can significantly reduce delays in STEMI treatment, which can result in improved short- and long-term clinical outcomes.

Keywords

• ST elevation myocardial infarction,electrocardiography,smartphone application,percutaneous coronary intervention

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