Emergency management of patients with ST-segment elevation myocardial infarction in Eastern Austria: A descriptive quality control study

Abstract

Background: Myocardial infarction is a time-critical condition and its outcome is determined by appropriate emergency care. Thus we assessed the efficacy of a supra-regional ST-segment elevation myocardial infarction (STEMI) network in Easternern Austria. Methods: The Eastern Austrian STEMI network serves a population of approx. 766.000 inhabitants within a region of 4186 km2. Established in 2007, it now comprises 20 pre-hospital emergency medical service (EMS) units (10 of these physician-staffed), 4 hospitals and 3 cardiac intervention centres. Treatment guidelines were updated in 2012 and documentation within a web-based STEMI registry became mandatory. For this retrospective qualitative control study, data from February 2012-April 2015 was assessed. Results: A total of 416 STEMI cases were documented, and 99% were identified by EMS within 6 (4.0-8.0) minutes after arrival. Median time loss between onset of pain and EMS call was 54 (20-135) minutes; response, pre-hospital and door-to-balloon times were 14 (10-20), 46 (37-59) and 45 (32-66) minutes, respectively. When general practitioners were involved, time between onset of pain and balloon inflation significantly increased from 180 (135-254) to 218 (155-348) minutes (p <30 min was achieved in 25.8% of all patients during the day vs. 11.6% during the night (p