ผลการพัฒนาระบบการดูแลผู้ป่วยโรคกล้ามเนื้อหัวใจตายเฉียบพลันชนิด STEMI โดยใช้ช่องทางด่วนในโรงพยาบาลนครปฐม

บทคัดย่อ

Objective : The objective of this research was to investigate general data and compare the outcomes between before and after launching Fast Track Managed Care System for Acute ST Elevation Myocardial Infarction (STEMI) patients.

Research Process: The retrospective study was employed in this research toward STEMI patient records, Nakhonpathom hospital. There were 2 phases of the study; 1) 51 patients were investigated before launching the system during May and October, 2009; 2) 68 patients were investigated after launching the system during January and May, 2010.

Results: After launching the system, findings were as follows: 1) there were 68 STEMI patients participated in this study, 65.13 years old in average. Participants consisted of male patients 75% and female patients 25%; 2) the highest risk factor was high blood pressure (51.5%) and smoking (39.7%), respectively; 3) most of patients were referred from primary care unit (58.8%) and also took Streptokinase (SK) (41.2%), however, some patients didn’t take SK because of reaching the hospital later than 12 hours (55 %); 4) door to needle time declined from 210 minutes to 75 minutes, (P < .01) ; 5) severe complications after administration of medication such as shock and cardiac arrest, declined from 38% to 10.7%; 6) death rate declined from 19.6 % to 11.8 %; 7) length of stay declined from 9.5 days to 4.5 days, (P < .05)

Conclusions : The Fast Track Managed Care System can provide short time for receiving treatment and reducing complication and death rate. So, they should improve referral system and well-inform this service to people.