A Lux1,2, J Vainer3,4, R A L J Theunissen4, L F Veenstra4,5, I Kasperski5, B C G Gho5, M Stein5, M Ilhan4,5, A W Ruiters5, P J C Winkler4,5, A van Beurden6, W Dohmen4, S Rasoul3,5, A W J van 't Hof3,4,5. 1. Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands. arpad.lux@mumc.nl. 2. Heart+Vascular Center, Maastricht University Medical Centre, Maastricht, The Netherlands. arpad.lux@mumc.nl. 3. Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands. 4. Heart+Vascular Center, Maastricht University Medical Centre, Maastricht, The Netherlands. 5. Department of Cardiology, Zuyderland Medical Centre, Heerlen, The Netherlands. 6. Department of Medical Management, Municipal Health Services South Limburg, Heerlen, The Netherlands.
Abstract
BACKGROUND: In the region of South Limburg, the Netherlands, a shared ST-elevation myocardial infarction (STEMI) networking system (SLIM network) was implemented. During out-of-office hours, two percutaneous coronary intervention (PCI) centres-Maastricht University Medical Centre and Zuyderland Medical Centre-are supported by the same interventional cardiologist. The aim of this study was to analyse performance indicators within this network and to compare them with contemporary European Society of Cardiology guidelines. METHODS: Key time indicators for an all-comer STEMI population were registered by the emergency medical service and the PCI centres. The time measurements showed a non-Gaussian distribution; they are presented as median with 25th and 75th percentiles. RESULTS: Between 1 February 2018 and 31 March 2019, a total of 570 STEMI patients were admitted to the participating centres. The total system delay (from emergency call to needle time) was 65 min (53-77), with a prehospital system delay of 40 min (34-47) and a door-to-needle time of 22 min (15-34). Compared with in-office hours, out-of-office hours significantly lengthened system delays (55 (47-66) vs 70 min (62-81), p < 0.001), emergency medical service transport times (29 (24-34) vs 35 min (29-40), p < 0.001) and door-to-needle times (17 (14-26) vs 26 min (18-37), p < 0.001). CONCLUSIONS: With its effective patient pathway management, the SLIM network was able to meet the quality criteria set by contemporary European revascularisation guidelines.
BACKGROUND: In the region of South Limburg, the Netherlands, a shared ST-elevation myocardial infarction (STEMI) networking system (SLIM network) was implemented. During out-of-office hours, two percutaneous coronary intervention (PCI) centres-Maastricht University Medical Centre and Zuyderland Medical Centre-are supported by the same interventional cardiologist. The aim of this study was to analyse performance indicators within this network and to compare them with contemporary European Society of Cardiology guidelines. METHODS: Key time indicators for an all-comer STEMI population were registered by the emergency medical service and the PCI centres. The time measurements showed a non-Gaussian distribution; they are presented as median with 25th and 75th percentiles. RESULTS: Between 1 February 2018 and 31 March 2019, a total of 570 STEMI patients were admitted to the participating centres. The total system delay (from emergency call to needle time) was 65 min (53-77), with a prehospital system delay of 40 min (34-47) and a door-to-needle time of 22 min (15-34). Compared with in-office hours, out-of-office hours significantly lengthened system delays (55 (47-66) vs 70 min (62-81), p < 0.001), emergency medical service transport times (29 (24-34) vs 35 min (29-40), p < 0.001) and door-to-needle times (17 (14-26) vs 26 min (18-37), p < 0.001). CONCLUSIONS: With its effective patient pathway management, the SLIM network was able to meet the quality criteria set by contemporary European revascularisation guidelines.
Entities:
Keywords:
Primary PCI network; Quality indicator; Regional care
Authors: Jiri Knot; Petr Widimsky; William Wijns; Ulf Stenestrand; Steen Dalby Kristensen; Arnoud Van' T Hof; Franz Weidinger; Magnus Janzon; Bjarne Linde Nörgaard; Jacob Thorsted Soerensen; Henri van de Wetering; Kristian Thygesen; Per-Adolf Bergsten; Christofer Digerfeldt; Adriaan Potgieter; Nadav Tomer; Jean Fajadet Journal: EuroIntervention Date: 2009-08 Impact factor: 6.534