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Trends of case-fatality rate by acute coronary syndrome in Portugal: Impact of a fast track to the coronary unit
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Resumo(s)
Introduction: Efforts were made to improve management of coronary disease as the fast-track system to the Coronary Unit. We aim to analyse case-fatality rates by acute coronary syndrome in Portugal from 2000 to 2016, mainly the impact of the fast-track system and the proportion of patients that activate the fast-track system.
Methods: We analysed monthly acute coronary syndrome case-fatality before and after the implementation of the fast-track system in 2007. Impact of the system was assessed through regression models for interrupted time-series. We calculated annual proportion of fast-track system admissions.
Results: After 2007 case-fatality by acute coronary syndrome decreased (β=-1.27, p-value < 0.01). The estimates obtained for ST Elevation Myocardial Infarction suggest a reduction of nearly 86 monthly deaths prevented after 2007. The highest percentage of patients admitted through the fast-track system was 35%.
Conclusions: Our results suggest fast-track system may have contributed to a decline in acute coronary syndrome case-fatality. However, more than half of patients were not admitted through the system. This should encourage health authorities to make efforts to ensure compliance.
Descrição
Palavras-chave
Acute Coronary Syndrome Cardiovascular Disease Epidemiology Fast-track System Estados de Saúde e de Doença Doenças Cardio e Cérebro-vasculares
Contexto Educativo
Citação
JRSM Cardiovasc Dis. 2019 May 24;8:2048004019851952. doi: 10.1177/2048004019851952. eCollection Jan-Dec 2019
Editora
SAGE Publications