[Acute myocardial infarction management in a hospital center with emergency ambulance service and intensive care unit, without cardiac catheterization laboratory].
OBJECTIVE
We report our experience about acute myocardial infarction management in a small hospital with no possibility of coronarography.


METHODS
In 1998, 60 patients were hospitalized for acute myocardial infarction < 10 days. We studied characteristics of patients, the management of myocardial infarction, the mortality.


RESULTS
Our population consisted of 83% of men and 17% of women with a mean age of 63.5 and 74 years respectively. An out-hospital doctor was first warned by 60% of patients. For hospitalization, the emergency ambulance service (SMUR) was used in 45% of cases, out-hospital doctors using these means of transport in 36% of cases. The global time of intervention was 18h30. The mean time for patients managed in the first sixth hours was 2h10. A thrombolysis was applied for 35% of patients (15% in prehospital that is to say 32% of "SMUR patients", and 20% in hospital). A transfer to the neighbouring university hospital for primary or rescue coronary angioplasty was decide for 41% of patients. A total of 77% of our patients underwent a coronarography. The global mortality at 10 days was 13.3% (< 75 years: 10.6%; > 75 years: 23%).


CONCLUSIONS
A low volume centre and with no possibility of coronarography can manage the acute phase of myocardial infarction with results closed to those of the literature.
Bordier
P
P
Centre hospitalier Pasteur de Langon, rue Paul-Langevin, 33210 Langon, France. Phibordier@aol.com
Comiant
I
I
Robert
F
F
Touchard
P
P
Chourbagi
M
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D005260:Female; D005602:France; D006761:Hospitals; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D010360:Patient Transfer; D011787:Quality of Health Care; D012737:Sex Factors; D015912:Thrombolytic Therapy; D013997:Time Factors