Outcome Of Patients With Acute Myocardial Infarction Who Were Presented To Emergency Department

概要

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We evaluated the profiles, therapeutic strategies, and outcome in 107 consecutive patients with acute myocardial infarction (AMI) transferred by ambulance to the emergency department (ED) of Keio University Hospital between January 1996 and December 2000. The prevalence of AMI among all patients who visited the ED (0.67%) was similar to that in the Tokyo Metropolitan area, indicating that the ED was not specialized in treatment of patients with critical illness or heart disease but open to all emergency patients, regardless of their category of disease or the severity of their condition. The onset-to-arrival interval was 209±245 minutes (median, 123 minutes). Of 107 patients, 101 were admitted and the rest either transferred to other hospitals (n=4) or died in the emergency room (n=2). Of 101 patients, 86 (85%) underwent emergency coronary angiographies and 81 emergency percutaneous coronary interventions. TIMI flow grades of 2 or 3 were achieved in target vessels of patients 76 (94%). Only one patient underwent intravenous thrombolysis. The number of in-hospital deaths for all patients with AMI was 11 (10.7%), whereas that of patients who underwent reperfusion therapy was 4 (4.9%). Further, we confirmed the effectiveness of the critical pathway in emergency room developed for efficacious cooperation between the emergency and cardiology departments.
一般社団法人日本救急医学会の論文