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Advisor(s)
Abstract(s)
Introdução: As doenças cardiovasculares são a principal causa de mortalidade e
morbilidade em todo o mundo. Na Europa, a doença cardíaca isquémica é responsável por
862 mil mortes em cada ano. Em Portugal, em 2015, morreram 27328 pessoas devido a
doença cardíaca isquémica, o que corresponde a 6,7% de todas as causas de morte. O
enfarte agudo do miocárdio é uma emergência médica que provoca a morte a cerca de
metade dos doentes nas primeiras horas após o início sintomas. A reperfusão precoce é o
tratamento de eleição. Por essa razão, reduzir o intervalo de tempo desde o início dos
sintomas até à terapia de reperfusão é uma prioridade.
Objetivos: Determinar o tempo de demora extra-hospitalar na pessoa com síndrome
coronária aguda e relacionar a influência de fatores sociodemográficos, clínicos e
farmacológicos relacionados com o tempo de demora extra-hospitalar na pessoa com
síndrome coronária aguda.
Material e Métodos: Estudo quantitativo, de natureza não experimental, descritivocorrelacional,
transversal e retrospetivo. A amostra foi constituída por 96 participantes e teve
por base uma população de doentes com cardiopatia isquémica admitidos no Laboratório de
Hemodinâmica e Cardiologia de Intervenção/Unidade de Cuidados Intensivos Coronários do
Centro Hospitalar Universitário do Algarve, E.P.E, provenientes do exterior com
acompanhamento da ambulância de Suporte Imediato de Vida, no período de 01 de janeiro
de 2014 a 31 de dezembro 2017.
Resultados: Os participantes apresentavam uma média de idade de 60,93 ± 12,98
anos, 79,2% eram do género masculino sendo que 88,5% apresentavam idade igual ou
superior a 46 anos. Cerca de 70,8% apresentavam enfarte agudo do miocárdio com
supradesnivelamento do segmento ST e da amostra, 56,2% dirigiram-se aos serviços de
saúde através de meios próprios. No total, 78,0% foram submetidos a intervenção coronária
percutânea primária. Quanto aos tempos de demora, 57,3% dos doentes têm o primeiro
contacto médico em tempo igual ou inferior a 120 minutos após o início da dor. O
eletrocardiograma é realizado em até 10 minutos em 46,9% dos doentes. Apesar de apenas
4,7% dos doentes realizaram a intervenção coronária percutânea primária em tempo igual
ou inferior a 60 minutos, cerca de 57,8% realizaram em tempo igual ou inferiores 120
minutos.
Conclusão: Os resultados mostram que o meio de acesso aos serviços de saúde
preferencialmente escolhido pelos doentes são os meios próprios e que quem procura ajuda
diferenciada apresenta tempos de demora inferiores otimizando, desta forma, o prognóstico.
Abstract Introduction: Cardiovascular diseases are the leading cause of mortality and morbidity worldwide. In Europe, ischemic heart disease accounts for 862 thousand deaths each year. In Portugal, in 2015, 27328 people died due to ischemic heart disease, which corresponds to 6,7% of all causes of death. Acute myocardial infarction is a medical emergency that causes death in about half of the patients in the first few hours after onset symptoms. Early reperfusion is the gold standard treatment. For this reason, reducing the time interval from onset of symptoms to reperfusion therapy is a priority. Objectives: To determine the time of prehospital delay in the person with acute coronary syndrome and to relate the influence of sociodemographic, clinical and pharmacological factors related to the time of prehospital delays in the person with acute coronary syndrome. Material and Methods: Quantitative, non-experimental, descriptive-correlational, transverse and retrospective study. The sample consisted of 96 participants and was based on a population of patients with ischemic heart disease admitted to the Hemodynamic Lab/Coronary Intensive Care Unit of the University Hospital Center of Algarve, from abroad with follow-up of Immediate Life Support Ambulance, from 1 January 2014 to 31 December 2017. Results: Participants had a mean age of 60.93 ± 12.98 years, 79.2% were male, and 88.5% were 46 years of age or older. About 70.8% had acute myocardial infarction with ST segment elevation and the sample, 56.2% went to the health services through their own means. In total, 78.0% underwent primary percutaneous coronary intervention. Regarding the delay times, 57.3% of patients have the first medical contact in less than 120 minutes after the onset of pain. The electrocardiogram is performed in up to 10 minutes in 46.9% of patients. Although only 4.7% of the patients underwent primary percutaneous coronary intervention in less than or equal to 60 minutes, approximately 57.8% performed in equal or less than 120 minutes. Conclusion: The results show that the means of access to health services chosen by the patients are the means and that those who seek differentiated help present lower delays, thus optimizing the prognosis.
Abstract Introduction: Cardiovascular diseases are the leading cause of mortality and morbidity worldwide. In Europe, ischemic heart disease accounts for 862 thousand deaths each year. In Portugal, in 2015, 27328 people died due to ischemic heart disease, which corresponds to 6,7% of all causes of death. Acute myocardial infarction is a medical emergency that causes death in about half of the patients in the first few hours after onset symptoms. Early reperfusion is the gold standard treatment. For this reason, reducing the time interval from onset of symptoms to reperfusion therapy is a priority. Objectives: To determine the time of prehospital delay in the person with acute coronary syndrome and to relate the influence of sociodemographic, clinical and pharmacological factors related to the time of prehospital delays in the person with acute coronary syndrome. Material and Methods: Quantitative, non-experimental, descriptive-correlational, transverse and retrospective study. The sample consisted of 96 participants and was based on a population of patients with ischemic heart disease admitted to the Hemodynamic Lab/Coronary Intensive Care Unit of the University Hospital Center of Algarve, from abroad with follow-up of Immediate Life Support Ambulance, from 1 January 2014 to 31 December 2017. Results: Participants had a mean age of 60.93 ± 12.98 years, 79.2% were male, and 88.5% were 46 years of age or older. About 70.8% had acute myocardial infarction with ST segment elevation and the sample, 56.2% went to the health services through their own means. In total, 78.0% underwent primary percutaneous coronary intervention. Regarding the delay times, 57.3% of patients have the first medical contact in less than 120 minutes after the onset of pain. The electrocardiogram is performed in up to 10 minutes in 46.9% of patients. Although only 4.7% of the patients underwent primary percutaneous coronary intervention in less than or equal to 60 minutes, approximately 57.8% performed in equal or less than 120 minutes. Conclusion: The results show that the means of access to health services chosen by the patients are the means and that those who seek differentiated help present lower delays, thus optimizing the prognosis.
Description
Keywords
Enfarte do miocárdio Factores de tempo Hemodinâmica Isquémia do miocárdio Serviços médicos de urgência Síndrome coronária aguda Acute coronary syndrome Emergency medical services Hemodynamics Myocardial infarction myocardial ischemia Time factors