PT450 Electrophysiology Procedure Sedation And Analgesia Patient Risk Assessment - A Patient Safety Focused Retrospective Review

Abstract

Fear of death P O ST E R A B ST R A C T S made of baseline demographics, clinical characteristics, DTBT and in-hospital, short-term and longer term mortality. Chi-square and Student’s t tests were undertaken to identify differences between the groups. Data were expressed as percentage or mean+/-SD. Results: A total of 176 STEMI patients were examined; 96 patients self-presented to hospital and 80 patients arrived to hospital by ambulance with pre-hospital notification. There were no differences in gender; 87% vs 85% male (p1⁄40.83); presentation in working hours; 47% vs 40% (p1⁄40.45); first cardiac admission 90% vs 94% (p1⁄40.60); diabetes 21% vs 14% (p1⁄40.24); Thrombolysis in Myocardial Infarction (TIMI) risk score greater than five 22% vs 27% (p1⁄40.48) and anterior infarction 41% vs 41% (p1⁄40.74), in patients who self-presented compared to those with pre-hospital notification respectively. Those who self-presented were younger (60+/-12 years vs 64+/-14 years; p1⁄40.05), and less frequently achieved a DTBT< 90 minutes (45% vs 95%; p<0.0001). The median DTBT for self-presenters was 103+/-45 mins vs 52+/-25.1 mins (p<0.001). Although the number of deaths were small, mortality for self-presenters was numerically higher inhospital (3.1% vs 1.3%; p1⁄40.62), at 30 days (3.1% vs 1.3%; p1⁄40.62) and at 12 months (4.2% vs 1.3%; p1⁄40.38). Conclusion: Self-presenters to hospital have longer DTBT. Whilst this did not translate to poorer mortality outcomes in this study, patients who self-present remain a challenge to systems of care designed to improve DTBT. Further examination is required to pinpoint the exact cause for delay in this group of STEMI patients to improve access to timely treatment. Disclosure of Interest: None Declared