Predictors of myocardial reperfusion in patients with ST-elevation myocardial infarction following thrombolytic treatment in rural community
© 2020, Walailak University. All rights reserved. This cross-sectional study aims to examine patient and hospital factors contributing to reperfusion following thrombolysis in patients with ST-segment elevation myocardial infarction (STEMI) in rural hospitals in Thailand. Access to reperfusion thera...
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th-mahidol.584252020-08-25T19:03:28Z Predictors of myocardial reperfusion in patients with ST-elevation myocardial infarction following thrombolytic treatment in rural community Patcharaporn Untaja Siriorn Sindhu Patricia Mary Davidson Orapan Thosingha Chukiat Viwatwongkasem Mahidol University Johns Hopkins School of Nursing Royal Thai Army Multidisciplinary © 2020, Walailak University. All rights reserved. This cross-sectional study aims to examine patient and hospital factors contributing to reperfusion following thrombolysis in patients with ST-segment elevation myocardial infarction (STEMI) in rural hospitals in Thailand. Access to reperfusion therapy for STEMI patients in rural areas is increasing in Thailand, yet clinical outcomes vary between settings and are inferior to recommended guidelines. Ten years after the introduction of thrombolytic treatment for rural patients undergoing STEMI, there is still a limited description of factors influencing the outcomes of thrombolytic treatment. Data were collected from 87 acute STEMI patients who had received thrombolytic treatment in 12 thrombolysis-capable hospitals located in rural areas. Demographic and clinical characteristics included patient response and treatment seeking behavior, witness response to the patient symptoms, waiting time for treatment, severity of illness, guideline adherence, and thrombolytic reperfusion. The results were: only 31 of 87 patients (35.63 %) received thrombolytic treatment within 30 min after arrival at the hospital. A total of 42 patients (48.28 %) had successful myocardial reperfusion following thrombolytic treatment. Logistic regression analysis revealed that guideline adherence (OR: 1.58; 95 % CI: 1.12-2.25), severity of illness (OR: 0.77; 95 % CI: 0.64-0.94), and patient response and treatment seeking behavior (OR: 1.47; 95 % CI: 1.01-2.04) were predictors of thrombolytic reperfusion. In rural areas, healthcare resources and transfer facilities are limited. Therefore, the improvement of patient awareness is needed. The clinical practice guidelines and consideration of pre-hospital factors should be promoted and the number of thrombolysis-capable hospitals should be increased. 2020-08-25T12:03:28Z 2020-08-25T12:03:28Z 2020-06-01 Article Walailak Journal of Science and Technology. Vol.17, No.6 (2020), 608-619 2228835X 16863933 2-s2.0-85087346708 https://repository.li.mahidol.ac.th/handle/123456789/58425 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85087346708&origin=inward |
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Multidisciplinary Patcharaporn Untaja Siriorn Sindhu Patricia Mary Davidson Orapan Thosingha Chukiat Viwatwongkasem Predictors of myocardial reperfusion in patients with ST-elevation myocardial infarction following thrombolytic treatment in rural community |
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© 2020, Walailak University. All rights reserved. This cross-sectional study aims to examine patient and hospital factors contributing to reperfusion following thrombolysis in patients with ST-segment elevation myocardial infarction (STEMI) in rural hospitals in Thailand. Access to reperfusion therapy for STEMI patients in rural areas is increasing in Thailand, yet clinical outcomes vary between settings and are inferior to recommended guidelines. Ten years after the introduction of thrombolytic treatment for rural patients undergoing STEMI, there is still a limited description of factors influencing the outcomes of thrombolytic treatment. Data were collected from 87 acute STEMI patients who had received thrombolytic treatment in 12 thrombolysis-capable hospitals located in rural areas. Demographic and clinical characteristics included patient response and treatment seeking behavior, witness response to the patient symptoms, waiting time for treatment, severity of illness, guideline adherence, and thrombolytic reperfusion. The results were: only 31 of 87 patients (35.63 %) received thrombolytic treatment within 30 min after arrival at the hospital. A total of 42 patients (48.28 %) had successful myocardial reperfusion following thrombolytic treatment. Logistic regression analysis revealed that guideline adherence (OR: 1.58; 95 % CI: 1.12-2.25), severity of illness (OR: 0.77; 95 % CI: 0.64-0.94), and patient response and treatment seeking behavior (OR: 1.47; 95 % CI: 1.01-2.04) were predictors of thrombolytic reperfusion. In rural areas, healthcare resources and transfer facilities are limited. Therefore, the improvement of patient awareness is needed. The clinical practice guidelines and consideration of pre-hospital factors should be promoted and the number of thrombolysis-capable hospitals should be increased. |
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Mahidol University |
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Mahidol University Patcharaporn Untaja Siriorn Sindhu Patricia Mary Davidson Orapan Thosingha Chukiat Viwatwongkasem |
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Article |
author |
Patcharaporn Untaja Siriorn Sindhu Patricia Mary Davidson Orapan Thosingha Chukiat Viwatwongkasem |
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Patcharaporn Untaja |
title |
Predictors of myocardial reperfusion in patients with ST-elevation myocardial infarction following thrombolytic treatment in rural community |
title_short |
Predictors of myocardial reperfusion in patients with ST-elevation myocardial infarction following thrombolytic treatment in rural community |
title_full |
Predictors of myocardial reperfusion in patients with ST-elevation myocardial infarction following thrombolytic treatment in rural community |
title_fullStr |
Predictors of myocardial reperfusion in patients with ST-elevation myocardial infarction following thrombolytic treatment in rural community |
title_full_unstemmed |
Predictors of myocardial reperfusion in patients with ST-elevation myocardial infarction following thrombolytic treatment in rural community |
title_sort |
predictors of myocardial reperfusion in patients with st-elevation myocardial infarction following thrombolytic treatment in rural community |
publishDate |
2020 |
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https://repository.li.mahidol.ac.th/handle/123456789/58425 |
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1763495686453592064 |