J Transcat Intervent.2020;28:eA20190028.
Results of an infarction care telemedicine program
Victor Eduardo de Almeida e França
, Pedro Arthur Ferreira Borges, Leonardo Veloso do Amaral, Max Weyler Nery, Debora Rodrigues, Fernanda Leão Martins, Fernando Henrique Fernandes, Adriano Gonçalves de Araújo, Flavio Passos Barbosa, Álvaro de Morais Júnior, Maurício Lopes Prudente, Giulliano Gardenghi
DOI: 10.31160/JOTCI202028A20190028
ABSTRACT
Background:
In Brazil, myocardial infarction affects approximately 300 thousand individuals per year, with mortality rate of 30%, and 80% of deaths occur in the first 24 hours. The telemedicine systems, such as Latin America Telemedicine Infarct Network, aim to optimize the stages from triage to treatment. Communication among the emergency care units and tertiary care services is known to be difficult, and the system aims to interconnect triage, physician and transport, facilitating transfer of patients to the cath lab. Therefore, implementing a telemedicine system for myocardial infarction and assessment of cardiovascular outcomes is justified. The objective of this study was to analyze the implementation of a telemedicine program, the characteristics of the population and the time intervals for treatment and transfer, in addition to in-hospital mortality.
Methods:
A cohort study with 110 individuals diagnosed as ST-segment elevation myocardial infarction in five emergency care units in the city of Aparecida de Goiânia, from November 2015 to August 2018.
Results:
In the period described, 110 patients were treated, mean age of 58±11 years, 72.2% were male, 53.6% hypertensive, 23.6% diabetic, 27.3% active smokers and 6.4% had a history of previous infarction. Of the patients admitted, 90.9% were submitted to primary percutaneous coronary intervention, and 8.2% of total number of patients died within the first 30 days.
Conclusion:
Implementing a telemedicine system resulted in reduced mortality as compared to the public health system. Despite better care, we observed longer transfer time, which justifies the need to implement fibrinolytic therapy in secondary care units.
Keywords: Angioplasty; Myocardial infarction; Telemedicine
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