بررسي فاصله زماني ورود بيمار مبتلا به انفاركتوس حاد ميوكارد به اورژانس تا شروع تزريق استرپتوكيناز

ASSESSMENT OF DOOR TO NEEDLE TIME FOR INITIATION OF STREPTOKINASE INFUSION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Background & Aims: Acute myocardial infarction (AMI) with ST- segment elevation in ECG is the most lethal form of the coronary syndrome that clot formation on the athero-sclerotic plaque has an important role in its pathophysiology. Therefore, reperfusion therapies such as streptokinase (SK) infusion with the shortest possible door- to- needle time was showed to result in a significant reduction in mortality and morbidity. This study is done in heart center of Taleghani- hospital of Urmia for assessment and improvement of Door- to- Needle Time in AMI patients. Materials & Methods: In a descriptive and cross- sectional study, 108 patients with STEMI and injection of SK were considered but only 93 patients were selected (the first half of 1381). Information of the patients were provided on a special sheets (check list) after interviews of patients by nurses and interns. Comparison of mean times was performed by student- T- test and one way variance analysis. Results: From 93 patients, 77 (82.7%) were male and 16 (17.3%) were female. Average Age of patients was 56.5 years. The mean time of the door to needle time was 89.25 ± 9.75 minutes. This mean time for, male patients was 86.5 ± 92.6 minutes and for female patients was 109.2 ± 13.5 minutes. Statistical difference was significant between the two sex groups. (p< 0.0001). Mean time for referral patients was 86 ± 10.74 minutes and for non- referral patients was (96.75 ± 16) minutes. Statistical difference was significant for these two groups (p<0.0001). Discussion: This study showed that the mean time of Door- To- Needle Time in our study was about 3 times more than goal time (< 30 minutes). This time in the female patients, old patients and non-referral patients were more than. Male patients, younger patients and referral patients, respectively. Different factors are responsible for Door-To- Needle Time prolongation such as: hospital personnelʹs, physicians, patients, environmental conditions, physical and the hospital statues and the some others factors.