การประเมินแนวทางการรักษาโรคกล้ามเนื้อหัวใจตายเฉียบพลันในโรงพยาบาลดำเนินสะดวก

บทคัดย่อ

          Acute myocardial infarction is a cardiovascular emergency condition with high risk for cardiac death, that needs prompt and appropriate treatment. Medical care team developed the clinical practice guideline for acute myocardial infarction patients in 2004. This retrospective study was conducted to evaluate result and quality of care for acute myocardial infarction patients by using process of care indicators and to detect the variance from the guideline. Data were collected from 19 pre-guideline and 18 post-guideline patients who were diagnosed acute ST segment elevation myocardial infarction (STEMI) and non ST segment elevation myocardial infarction (NSTEMI). The study showed better quality of care after guideline implementation. The appropriately thrombolytic drug usage in STEMI patients increased from 53.85% to 80% with statistic significance. The patients receiving aspirin immediately after diagnosis and the lipid profile assessment increased from 78.9% to 83.8% and from 63.2% to 72.2% with statistic significance. The average length of hospitalization and mortality rate decreased from 6.74 ± 2.746 days to 4.56 ± 3.294 days and from 36.8% to 27.8% with statistic significance. The patients receiving B-blocker rose from 36.8% to 4414% but without statistic significance. The guideline was varied by patient complication and system.