PMID- 26693879
OWN - NLM
STAT- MEDLINE
DCOM- 20171120
LR  - 20180213
IS  - 1556-3669 (Electronic)
IS  - 1530-5627 (Linking)
VI  - 22
IP  - 7
DP  - 2016 Jul
TI  - Impact of Chest Pain Protocol with Access to Telemedicine on Implementation of 
      Pharmacoinvasive Strategy in a Private Hospital Network.
PG  - 549-52
LID - 10.1089/tmj.2015.0178 [doi]
AB  - BACKGROUND: Brazilian registries have shown a gap between evidence-based 
      therapies and real treatments. We aim to compare the use of the pharmacoinvasive 
      strategy and mortality in patients with ST elevation myocardial infarction 
      (STEMI) transferred pre- and post-chest pain protocol with access to telemedicine 
      (CPPT) in a private hospital network. MATERIALS AND METHODS: A CPPT was 
      implemented in 22 private emergency departments in 2012. Emergency physicians and 
      nurses of all facilities were trained to disseminate the information to comply 
      with a chest pain protocol focusing on reperfusion therapy (pharmacoinvasive 
      strategy) for STEMI. To conduct clinical discussions using telemedicine, a 
      cardiologist from a reference hospital in cardiology (RHC) was available 
      24 h/day, 7 days/week. Using the database of all consecutive admissions, we 
      compared the data of patients with STEMI transferred to the RHC in 2011 
      (pre-CPPT) and 2013-2014 (post-CPPT). RESULTS: We included 376 patients (113 
      pre-CPPT and 263 post-CPPT) with STEMI. All patients admitted in the RHC were 
      transferred from the 22 emergency departments. Comparing pre-CPPT and post-CPPT, 
      we did not find differences regarding age, gender, hypertension, dyslipidemia, 
      diabetes, smoking, previous myocardial infarction, or Killip classification. 
      However, the use of CPPT was associated with a greater use of pharmacoinvasive 
      strategy (55.8% versus 38%; p = 0.002) and a trend toward lower in-hospital 
      mortality (3% versus 8%; p = 0.06). CONCLUSIONS: The implementation of a CPPT was 
      associated with a significant increase in the use of pharmacoinvasive strategy in 
      patients with STEMI and a trend toward reduced in-hospital mortality in a private 
      hospital network.
FAU - Macedo, Thiago Andrade
AU  - Macedo TA
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - de Barros E Silva, Pedro Gabriel Melo
AU  - de Barros E Silva PG
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - Simoes, Sheila Aparecida
AU  - Simoes SA
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - Okada, Mariana Yumi
AU  - Okada MY
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - Garcia, Jose Carlos Teixeira
AU  - Garcia JC
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - Sampaio, Marcio Campos
AU  - Sampaio MC
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - Dantas, Roberto Nery Jr
AU  - Dantas RN Jr
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - Oliveira, Roger Pereira
AU  - Oliveira RP
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - Rocha, Liliane Gomes
AU  - Rocha LG
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - da Cunha Lopes, Bernardo Baptista
AU  - da Cunha Lopes BB
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - Frigini, Tiago
AU  - Frigini T
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
FAU - Furlan, Valter
AU  - Furlan V
AD  - Emergency Department, Hospital TotalCor , Sao Paulo, Brazil .
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20151222
PL  - United States
TA  - Telemed J E Health
JT  - Telemedicine journal and e-health : the official journal of the American 
      Telemedicine Association
JID - 100959949
SB  - IM
MH  - Aged
MH  - Brazil
MH  - Clinical Protocols/*standards
MH  - Female
MH  - Hospital Mortality/trends
MH  - Hospitals, Private/*organization & administration/standards
MH  - Humans
MH  - Information Dissemination/*methods
MH  - Inservice Training
MH  - Male
MH  - Middle Aged
MH  - ST Elevation Myocardial Infarction/*therapy
MH  - Telemedicine/*organization & administration/standards
OTO - NOTNLM
OT  - chest pain protocol
OT  - myocardial infarction
OT  - telemedicine
EDAT- 2015/12/24 06:00
MHDA- 2017/11/29 06:00
CRDT- 2015/12/24 06:00
PHST- 2015/12/24 06:00 [entrez]
PHST- 2015/12/24 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
AID - 10.1089/tmj.2015.0178 [doi]
PST - ppublish
SO  - Telemed J E Health. 2016 Jul;22(7):549-52. doi: 10.1089/tmj.2015.0178. Epub 2015 
      Dec 22.