Treatment Approachments Of St Segment Elevated Myocardial İnfarction Patients İn One Hundred Hospitals Among Seven Cities At The Aegean Region

INTRODUCTIONAcute coronary syndromes are major complaints of emergency medical admissions and are major causes of mortality and morbidity in the world. In Turkey, deaths related to cardiovascular diseases are 47.7% of all deaths. If ST segment elevated myocardial infarction (STEMI) patients aren?t recognized early and untreated promptly, mortality increases every 30 minutes. Early treatment is crucial to prevent morbidity and mortality. In this study, we aimed research the treatment modalities, decision of the STEMİ patients and factors contributing, at the hospitals in Aegean Region.METHODSPhysicians working in 110 hospitals in cities of Izmir, Manisa, Usak, Mugla, Afyon, Aydın, Denizli and Kutahya of the Aegean Region were planned to be considered in this study. In the study form, physicians? institute, specialty area, age, sex, availability of intensive care unit, availability of primary percutaneous coronary intervention (PCI), distance to the nearest coronary angiography unit, final decision of the patients (transport to another hospital or admission to current hospital) and ancillary therapies were questioned. Study forms were sent to physicians of mentioned hospitals. In each institute, two study forms were completed by admitting physician of the emergency room and the consulting physician.RESULTSAt the end of the survey, 100 hospitals were reached and 182 study forms were completed. In the study, 69% of hospitals were in district while 31% were in city centers and 45% of hospitals had intensive care units for STEMI patients. PCI was performed in only 18 hospitals (18%). Primary PCI was performed in only five hospitals as the reperfusion method. The final decision for STEMI patients was to transfer to another hospital in 58%, to admit to current hospital in 35% and either transport or admission in 7% of hospitals. In hospitals where patients were transported, 60% of the physicians were general practitioners while in hospitals where patients were admitted, 70% of the physicians were specialists.CONCLUSIONWe concluded that at the Aegean region hospitals, general reperfusion strategy for STEMI patients is thrombolytic therapy. Thrombolytic agents are more commonly used in hospitals in city centers, which have intensive care units and consulting physicians. However the capability of performing PCI of a hospital did not affect the usage of thrombolytic agents for STEMI patients as the primary preferred choice of reperfusion method in our study. Final decision of STEMI patients depends on location of the hospital, availability of the intensive care unit and catheter laboratory and presence of the specialists in the hospital.