ST Yükselmeli Miyokart İnfarktüslü Hastaların Başvuru Anındaki Ölüm Riskine Başvuru Saatinin Etkisi

Yıl 2015, Cilt: 18 Sayı: 2, 71 - 75, 03.08.2015

Uğur Arslantaş Göktürk İpek Fatih Karakaş İsa Öner Yüksel Emine Bilen Ayşe Yaşar Mehmet Bilge

Öz

Giriş:
Önceki çalışmalarda hastane başvuru zamanının
(hafta içine göre hafta sonu, mesai saatlerine göre mesai dışı saatler) ST
yükselmeli miyokart infarktüsü (STEMİ) ölüm oranına farklı oranda
etkilemektedir. Fakat bu çalışmalarda başvuru anındaki hasta ölüm riski
incelenmemiştir.

Hastalar
ve Yöntem: Ocak 2006 ile Mart 2009
tarihleri arasında reperfüzyona uygun STEMİ 228 hasta çalışmaya dâhil edildi.
Hastalar başvuru saatine göre gece (24.00 ile 05.59 saatleri arası), sabah
(06.00 ile 11.59 saatleri arası), öğlen (12.00 ile 17.59 saatleri arası) ve
akşam (18.00 ile 23.59 saatleri arası) olarak gruplara ayrıldı. Başvuru
saatiyle başvuru anındaki hastane ölüm riski TIMI risk indeksi [Kalp hızı x
(yaş/10)2 /Sistolik kan basıncı] kullanılarak hesaplandı.

Bulgular:
Başvuru zamanına göre, hastalar yaş, kalp hızı,
sistolik kan basıncı, Killip sınıf > 1 ya da infarkt süresi açısından
farklılık göstermiyorlardı. Hastane içi ölüm ön görücüsü TRI, gruplar arasında
farklılık göstermemekteydi (p: 0.69)

Sonuç: STEMİ hastaları için ölüm riski başvuru saatine göre
belirgin farklılık göstermemektedir. Sağlık hizmeti sağlayıcılar, mesai içi ve
dışı saatlerde sağlık sisteminin etkili çalışmasını sağlamaya devam
etmelidirler ve kanıta dayalı tedavilere zamanında ulaşmada iyileşmeyi
amaçlamalıdırlar.

Anahtar Kelimeler

STEMİ, TIMI risk indeksi, prognoz

The Impact of the Time of Admission on Baseline Mortality Risk in Patients with ST Elevation Myocardial Infarction

Öz

Introduction: Prior studies have reported a differential mortality
effect of the time of admission (weekdays vs. weekends, regular hours vs. off
hours) in patients with ST elevation myocardial infarction (STEMI). However,
these studies did not evaluate the relationship between the admission hours and
mortality risk at admission.

Patients and Methods: A
total of 228 patients presenting with reperfusion eligible acute STEMI between
January 2006 and March 2009 were enrolled in this study. With respect to
admission hours, patients were divided into 4 groups: night (between 24.00 and
05.59 hours), morning (between 06.00 and 11.59 hours), afternoon (between 12.00
and 17.59 hours) and evening (between 18.00 and 23.59 hours)]. The relationship
between admission hours and in hospital mortality risk were examined using the
TIMI risk index (TRI) [heart rate x (age/10)2 /systolic blood pressure].

Results: Patients in
different groups of admission hours were not significantly different in terms
of age, heart rate, systolic blood pressure, Killip class > 1 or time to
infarction. TRI, a predictor of in-hospital mortality, was also not
significantly different between these groups defined using 6-hour time
intervals (p: 0.69).

Conclusion: Time of admission did not
significantly affect the mortality risk at presentation in patients with STEMI.
Healthcare providers should continue to work to enhance the healthcare system
during regular and off-hours and to reduce existing disparities in cardiac care
through multifaceted initiatives aiming to improve the timely delivery of
evidence-based therapies.

Anahtar Kelimeler

STEMI, TIMI risk index (TRI), prognosis

Kaynakça

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