Uğur ARSLANTAŞ, Göktürk İPEK, Fatih KARAKAŞ, İsa Öner YÜKSEL, Emine BİLEN, Ayşe YAŞAR, Mehmet BİLGE

ST Yükselmeli Miyokart İnfarktüslü Hastaların Başvuru Anındaki Ölüm Riskine Başvuru Saatinin Etkisi

Giriş: Önceki çalışmalarda hastane başvuru zamanının (hafta içine göre hafta sonu, mesai saatlerine göre mesai dışı saatler) ST yükselmeli miyokart infarktüsü (STEMİ) ölüm oranına farklı oranda etkilemektedir. Fakat bu çalışmalarda başvuru anındaki hasta ölüm riski incelenmemiştir. Hastalar ve Yöntem: Ocak 2006 ile Mart 2009 tarihleri arasında reperfüzyona uygun STEMİ 228 hasta çalışmaya dâhil edildi. Hastalar başvuru saatine göre gece (24.00 ile 05.59 saatleri arası), sabah (06.00 ile 11.59 saatleri arası), öğlen (12.00 ile 17.59 saatleri arası) ve akşam (18.00 ile 23.59 saatleri arası) olarak gruplara ayrıldı. Başvuru saatiyle başvuru anındaki hastane ölüm riski TIMI risk indeksi [Kalp hızı x (yaş/10)2 /Sistolik kan basıncı] kullanılarak hesaplandı. Bulgular: Başvuru zamanına göre, hastalar yaş, kalp hızı, sistolik kan basıncı, Killip sınıf > 1 ya da infarkt süresi açısından farklılık göstermiyorlardı. Hastane içi ölüm ön görücüsü TRI, gruplar arasında farklılık göstermemekteydi (p: 0.69) Sonuç: STEMİ hastaları için ölüm riski başvuru saatine göre belirgin farklılık göstermemektedir. Sağlık hizmeti sağlayıcılar, mesai içi ve dışı saatlerde sağlık sisteminin etkili çalışmasını sağlamaya devam etmelidirler ve kanıta dayalı tedavilere zamanında ulaşmada iyileşmeyi amaçlamalıdırlar.

Anahtar Kelimeler:

STEMİ, TIMI risk indeksi, prognoz

The Impact of the Time of Admission on Baseline Mortality Risk in Patients with ST Elevation Myocardial Infarction

Introduction: Prior studies have reported a differential mortality effect of the time of admission (weekdays vs. weekends, regular hours vs. off hours) in patients with ST elevation myocardial infarction (STEMI). However, these studies did not evaluate the relationship between the admission hours and mortality risk at admission. Patients and Methods: A total of 228 patients presenting with reperfusion eligible acute STEMI between January 2006 and March 2009 were enrolled in this study. With respect to admission hours, patients were divided into 4 groups: night (between 24.00 and 05.59 hours), morning (between 06.00 and 11.59 hours), afternoon (between 12.00 and 17.59 hours) and evening (between 18.00 and 23.59 hours)]. The relationship between admission hours and in hospital mortality risk were examined using the TIMI risk index (TRI) [heart rate x (age/10)2 /systolic blood pressure]. Results: Patients in different groups of admission hours were not significantly different in terms of age, heart rate, systolic blood pressure, Killip class > 1 or time to infarction. TRI, a predictor of in-hospital mortality, was also not significantly different between these groups defined using 6-hour time intervals (p: 0.69). Conclusion: Time of admission did not significantly affect the mortality risk at presentation in patients with STEMI. Healthcare providers should continue to work to enhance the healthcare system during regular and off-hours and to reduce existing disparities in cardiac care through multifaceted initiatives aiming to improve the timely delivery of evidence-based therapies.

Keywords:

STEMI, TIMI risk index (TRI), prognosis,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi