Fallacy of Median Door-to-ECG Time: Hidden Opportunities for STEMI Screening Improvement.
STEMI
emergency medicine
guidelines
myocardial infarction
screening
timely care
triage
Journal
Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524
Informations de publication
Date de publication:
03 05 2022
03 05 2022
Historique:
pubmed:
3
5
2022
medline:
6
5
2022
entrez:
2
5
2022
Statut:
ppublish
Résumé
Background ST-segment elevation myocardial infarction (STEMI) guidelines recommend screening arriving emergency department (ED) patients for an early ECG in those with symptoms concerning for myocardial ischemia. Process measures target median door-to-ECG (D2E) time of 10 minutes. Methods and Results This 3-year descriptive retrospective cohort study, including 676 ED-diagnosed patients with STEMI from 10 geographically diverse facilities across the United States, examines an alternative approach to quantifying performance: proportion of patients meeting the goal of D2E≤10 minutes. We also identified characteristics associated with D2E>10 minutes and estimated the proportion of patients with screening ECG occurring during intake, triage, and main ED care periods. We found overall median D2E was 7 minutes (IQR:4-16; range: 0-1407 minutes; range of ED medians: 5-11 minutes). Proportion of patients with D2E>10 minutes was 37.9% (ED range: 21.5%-57.1%). Patients with D2E>10 minutes, compared to those with D2E≤10 minutes, were more likely female (32.8% versus 22.6%,
Identifiants
pubmed: 35492001
doi: 10.1161/JAHA.121.024067
pmc: PMC9238601
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e024067Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL133477
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002243
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000445
Pays : United States
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