Effects of a clinical pathway on patients with acute myocardial infarction in the emergency department

CHEN Wei; HE Hongyan; JI Da; and SHEN Hong.

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Medical Journal of the Chinese People Armed Police Forces ›› 2012, Vol. 23 ›› Issue (9) : 787-790.

Effects of a clinical pathway on patients with acute myocardial infarction in the emergency department

CHEN Wei,HE Hongyan,JI Da,and SHEN Hong.

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Abstract

Objective To measure the effect of a clinical pathway on patients with acute myocardial infarction (AMI) in emergency departments. Methods The effectiveness of a multidisciplinary clinical pathway for AMI patients over the past seventeen years in our emergency department was retrospectively analyzed. The clinical pathways used before 2004 and after 2004 were compared. The measurement involed the time to room, time of door-to-needle, time of door-to-balloon. We also compared the effect of clinical outcomes of facilitated PCI (venous thromblysis plus PCI, percutaneous coronary intervention ) and primary PCI. Results A total of 1134 ST-segment elevation myocardial infarction (STEMI) patients were analyzed. The number of acute PCI patients increased while the time of door-to-needle time and door-to-balloon decreased significantly since 2004. However, time to room didn’t change much. Facilitated PCI could not improve in-hospital survival compared with the primary PCI. Conclusion The clinical pathway can shorten the time of door-to-needle and door-to-balloon for AMI patients. Facilitated PCI fails to improve the clinical outcomes when compared with primary PCI.

Key words

clinical pathway / acute myocardial infarction / door-to-needle time / door-to-balloon time

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CHEN Wei,HE Hongyan,JI Da,and SHEN Hong.. Effects of a clinical pathway on patients with acute myocardial infarction in the emergency department[J]. Medical Journal of the Chinese People Armed Police Forces. 2012, 23(9): 787-790

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