[Care of ST elevated myocardial infarction patients in Vendée in 2008: observational and descriptive study].
OBJECTIVE
Estimating the quality of care of the patients presenting an ST-elevation myocardial infarction in Vendee.


METHODS
Prospective observational study carried out over the year 2008. Included patients presenting a myocardial infarction for less than 24 hours, they were alive when emergency team arrived, and were taken care of by the SMUR, the emergencies or the cardiology of the hospital of La Roche-sur-Yon.


RESULTS
Two hundred and seventeen patients were included, 163 men and 54 women, average age: 65 years. Fifty-six percent of the patients called initially the emergency medical service, half of those within an hour after pain began. Seventy-two percent of them were looked after by a SMUR. Twenty-six percent consulted initially a general practitioner, and one third of those were redirected towards the emergency medical service. Thirty percent of all patients followed the ideal procedure defined by succession of chest pain, emergency medical service call, SMUR, angioplasty or fibrinolysis. The average time between the ECG and the fibrinolysis is 36 minutes, or of the arrival in coronarography room is 105 minutes. The balloon is inflated 42 minutes later. Eighty-six percent of the patients taken care of in the acute phase benefited from a strategy of reperfusion, primary angioplasty (63%) or fibrinolysis (21%). Ninety percent of revascularisations were successful.


CONCLUSIONS
In the case of the chest pain, the emergency medical service is under-used. The number of revascularised patients is satisfactory, but the whole procedure takes too much time, especially when the treatment is the angioplasty.
Trebouet
E
E
Samu, SMUR, urgences, CHD Les Oudairies, boulevard Stéphane-Moreau, 85925 La Roche-Sur-Yon cedex 09, France. eve.trebouet@chd-vendee.fr
Fradin
P
P
Orion
L
L
Dimet
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D002985:Clinical Protocols; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005602:France / Q000453:epidemiology; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D011787:Quality of Health Care; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D005343:Fibrinolytic Agents