Abstract
BackgroundThis study aimed to explore the ST segment elevation myocardial infarction (STEMI) management practices of emergency medicine specialists working in various healthcare institutions of seven different geographical regions of Turkey, and to examine the characteristics of STEMI presentation and patient admissions in these regions.MethodsWe included 225 emergency medicine specialists working in all geographical regions of Turkey. We e-mailed them a 20-item questionnaire comprising questions related to their STEMI management practices and characteristics of STEMI presentation and patient admissions.ResultsThe regions were not significantly different with respect to primary percutaneous coronary intervention (PCI) resources (p = 0.286). Sixty six point two percent (66.2%) of emergency specialists stated that patients presented to emergency within 2 hours of symptom onset. Forty three point six percent (43.6%) of them contacted cardiology department within 10 minutes and 47.1% within 30 minutes. In addition, 68.3% of the participants improved themselves through various educational activities. The Southeastern Anatolian region had the longest time from symptom onset to emergency department admission and the least favorable hospital admission properties, not originating from physicians or 112 emergency healthcare services.ConclusionSeventy point seven percent (70.7%) of the emergency specialists working in all geographical regions of Turkey comply with the latest guidelines and current knowledge about STEMI care; they also try to improve themselves, and receive adequate support from 112 emergency healthcare services and cardiologists. While inter-regional gaps between the number of primary PCI capable centers and quality of STEMI care progressively narrow, there are still issues to address, such as delayed patient presentation after symptoms onset and difficulties in patient admission.
Highlights
ST elevation myocardial infarction (STEMI) is a type of acute coronary syndrome in which coronary plaque rupture, thrombosis, vasospasm, embolization, or dissection leads to complete occlusion of one of the major epicardial coronary arteries, resulting in myocardial injury and necrosis within a period of minutes to hours [1]
Seventy point seven percent (70.7%) of the emergency specialists working in all geographical regions of Turkey comply with the latest guidelines and current knowledge about segment elevation myocardial infarction (STEMI) care; they try to improve themselves, and receive adequate support from 112 emergency healthcare services and cardiologists
Fibrinolytics maintain their importance in the management of STEMI, mainly reserved for percutaneous coronary intervention (PCI)-incapable centers or whenever time to transfer of patients to PCI-capable centers is delayed or impossible [7, 8]
Summary
ST elevation myocardial infarction (STEMI) is a type of acute coronary syndrome in which coronary plaque rupture, thrombosis, vasospasm, embolization, or dissection leads to complete occlusion of one of the major epicardial coronary arteries, resulting in myocardial injury and necrosis within a period of minutes to hours [1]. PCI is the gold standard in the treatment of STEMI provided that it is performed in a timely manner and there are sufficient trained staff and equipment [7, 8]. Fibrinolytics maintain their importance in the management of STEMI, mainly reserved for PCI-incapable centers or whenever time to transfer of patients to PCI-capable centers is delayed or impossible [7, 8]. This study aimed to explore the ST segment elevation myocardial infarction (STEMI) management practices of emergency medicine specialists working in various healthcare institutions of seven different geographical regions of Turkey, and to examine the characteristics of STEMI presentation and patient admissions in these regions
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