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Chain of care in chest pain-differenes beteen three hospitals in an urban area.
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2013 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 166, no 2, 440-7 p.Article in journal (Refereed)
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Abstract [en]

AIM: To describe differences in treatment and delay times in acute chest pain at the three hospitals in Göteborg, Sweden. METHODS: All patients admitted to the three hospitals within Sahlgrenska University (SU) (Sahlgrenska: SU/S, Östra: SU/Ö and Mölndal: SU/M) with acute chest pain during 3 months in 2008 were evaluated for diagnosis, early treatment and outcome. RESULTS: In all, 2588 visits by 2393 patients were included (visits n=1253 SU/S; n=853 SU/Ö; n=482 SU/M) of which 50%, 63% and 51% were hospitalised (p<0.0001). Among hospitalised patients, a diagnosis of ACS was reported in 26%, 9% and 22% respectively (p<0.0001). Among ACS patients, 83%, 66% and 57% respectively underwent coronary angiography (p=0.004). The median delay to coronary angiography in ST-elevation myocardial infarction (STEMI) was 42 min at SU/S, 3h 47 min at SU/Ö and 2h 34 min at SU/M (p=0.008). The corresponding values for coronary angiography in unstable coronary artery disease were 42h 7min, 48h 35 min and 123h 42 min (p=0.007). Overall mortality at 30 days was 3.6%, 3.2% and 1.5% (NS) and, at 1 year, it was 9.9%, 9.6% and 7.3% respectively (NS). CONCLUSION: In acute chest pain in the Municipality of Göteborg, there was a marked difference between hospitals in: 1) the percentage of hospitalised patients, 2) the percentage of ACS among hospitalised patients and 3) the delay to and rate of coronary angiography. The clinical consequences of these deviations remain to be proven.

Place, publisher, year, edition, pages
Elsevier Ireland Ltd , 2013. Vol. 166, no 2, 440-7 p.
Keyword [sv]
Vårdutveckling
National Category
Cardiac and Cardiovascular Systems
Research subject
Integrated Caring Science
Identifiers
URN: urn:nbn:se:hb:diva-1681DOI: 10.1016/j.ijcard.2011.10.139ISI: 000319510200033PubMedID: 22119114Local ID: 2320/13052OAI: oai:DiVA.org:hb-1681DiVA: diva2:869750
Available from: 2015-11-13 Created: 2015-11-13

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