Thrombolysis for acute myocardial infarction in Australasia 1999.
OBJECTIVE
To describe revascularization practice for acute myocardial infarction in a sample of Australasian hospitals during 1999.


METHODS
Survey for the 1999 calendar year.


METHODS
Hospitals with Australasian College for Emergency Medicine-accredited emergency departments in Australia and New Zealand.


METHODS
Forty-eight hospitals of 80 surveyed (60%), comprising 15 tertiary and 33 non-tertiary hospitals.


METHODS
Time from arrival in emergency department to initiation of thrombolytic therapy, site of therapy, agent used, mortality and intracranial haemorrhage rates.


RESULTS
Approximately 30% of patients with acute myocardial infarction had revascularization therapy. Sixty-two per cent of patients receiving thrombolytics were given this treatment in the emergency department, the remainder in the coronary care unit. Overall median door-to-needle times were 35.0 min emergency department versus 48.3 min coronary care unit. Streptokinase was used for 58.3% of thrombolysis. In-hospital mortality of thrombolysed patients was 6.7% in the emergency department versus 4.3% in the coronary care unit with intracranial haemorrhage rates of 0.8% emergency department and 0.7% coronary care unit.


CONCLUSIONS
Overall times to thrombolysis and outcome rates in this sample were within internationally reported figures. Emergency department times were shorter than in coronary care unit.
Mountain
David
D
Emergency Department, Sir Charles Gairdner Hospital, Department of Emergency Medicine, University of Western Australia, Perth, Western Australia, Australia. david.mountain@health.wa.gov.au
Jelinek
George A
GA
O'Brien
Debra L
DL
Ingarfield
Sharyn L
SL
Jacobs
Ian G
IG
Lynch
Dania M
DM
D000368:Aged; D001315:Australia; D004636:Emergency Service, Hospital; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D009520:New Zealand; D013300:Streptokinase / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*
D005343:Fibrinolytic Agents; D013300:Streptokinase