PMID- 18697380
OWN - NLM
STAT- MEDLINE
DCOM- 20081017
LR  - 20080813
IS  - 0125-2208 (Print)
IS  - 0125-2208 (Linking)
VI  - 91
IP  - 6
DP  - 2008 Jun
TI  - Clinical outcomes of fast track managed care system for acute ST elevation 
      myocardial infarction (STEMI) patients: Chonburi Hospital experience.
PG  - 822-7
AB  - OBJECTIVE: To evaluate the clinical outcomes of fast track managed care system 
      for STEMI at Chonburi Hospital. MATERIAL AND METHOD: Descriptive review of 
      clinical parameters from STEMI patients who participated in fast track managed 
      care system. RESULTS: There were 56 STEMI consecutive cases admitted to the 
      intensive care unit (ICU) between August 1, 2006 and January 1, 2007 in the pilot 
      project of the fast track managed care system (43 men and 13 women). The average 
      age was 61 years. The coronary artery disease (CAD) risk factors were smoking 
      (66%), hypertension (41%), diabetes mellitus (44%), and dyslipidemia (46%). The 
      atherosclerosis diseases were chronic renal disease (3.6%), cerebrovascular 
      disease (7%), and peripheral vascular disease (3.6%). The average length of stay 
      was 5.7 days. The median door to needle time and door to balloon time were 49.8 
      and 130.5 minutes respectively. Ten patients developed complications, which 
      included gastrointestinal bleeding and ecchymosis. The mortality rate was 26.8% 
      (15 cases). The current medications such as ACE-I, betablocker, and dopamine 
      between survivors and non-survivors were compared and showed statistical 
      significance. The creatinine and creatine phosphokinase (CPK) were significantly 
      different between survivors and non-survivors. There was a decrease trend of the 
      overall mortality rate in STEMI patients between July 2006 and January 2008 
      following the launch of the fast track managed care system. CONCLUSION: When 
      compared to a previous study, the fast track system could decrease mortality 
      rate, door to needle time, and door to balloon time. The fast track should be 
      included in routine hospital guideline for management of STEMI patients.
FAU - Tantisiriwat, Worawit
AU  - Tantisiriwat W
AD  - Department of Medicine, Chonburi Hospital, Chonburi, Thailand.
FAU - Jiar, Wiwat
AU  - Jiar W
FAU - Ngamkasem, Hathaichanok
AU  - Ngamkasem H
FAU - Tantisiriwat, Suvimol
AU  - Tantisiriwat S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Thailand
TA  - J Med Assoc Thai
JT  - Journal of the Medical Association of Thailand = Chotmaihet thangphaet
JID - 7507216
SB  - IM
MH  - Aged
MH  - Coronary Artery Disease/drug therapy/*physiopathology
MH  - Female
MH  - Health Maintenance Organizations/*organization & administration
MH  - Humans
MH  - Intensive Care Units/organization & administration
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*drug therapy/mortality/physiopathology
MH  - Pilot Projects
MH  - Risk Factors
MH  - Survivors
MH  - Thailand
MH  - Treatment Outcome
EDAT- 2008/08/14 09:00
MHDA- 2008/10/18 09:00
CRDT- 2008/08/14 09:00
PHST- 2008/08/14 09:00 [pubmed]
PHST- 2008/10/18 09:00 [medline]
PHST- 2008/08/14 09:00 [entrez]
PST - ppublish
SO  - J Med Assoc Thai. 2008 Jun;91(6):822-7.