The effect of the management of patients diagnosed with st-segment elevation myocardial infarction presenting during and outside working hours and undergoing percutaneous coronary intervention in the emergency department of a university hospital on prognosis

This thesis was conducted to evaluate the impact of management durations during working and non-working hours on the prognosis of STEMI patients presenting to the Emergency Department of Eskişehir Osmangazi University Hospital. The study was carried out on 186 STEMI patients who presented to the hospital between January 1, 2023, and December 31, 2023. Of these patients, 54 (29%) presented during working hours, and 132 (71%) during non-working hours. The gender distribution revealed that 79.6% of the patients were male. Among the patients, 18% had a history of previous myocardial infarction, 39% were smokers, and 49% had hypertension, indicating the influence of these factors on the development of STEMI. The mean PTCA time was 32.13 minutes for the working hours group and 43.00 minutes for the non-working hours group (p = 0.001). Door-to-balloon times were below 60 minutes in 85.2% of patients during working hours and 87.2% during non-working hours (p = 0.909). Mortality rates were 7.41% in the working hours group and 6.82% in the non-working hours group (p = 1.000), showing no significant difference in mortality between the two groups. This suggests that effective treatment protocols and management processes were applied consistently during both periods. The findings highlight the critical importance of prompt and accurate interventions in the emergency department for successful treatment outcomes.In conclusion, the implementation of rapid diagnostic and treatment processes in the emergency department has the potential to improve the prognosis of STEMI patients. The results of this study aim to contribute to future research and the enhancement of management standards for STEMI patients. Key Words: STEMI, Working hours, Outside working hours, Prognosis