O impacto da transferência inter-hospitalar na mortalidade dos pacientes com IAMCSST que tiveram acesso direto ou indireto à ICP primária– registro victim

Abstract

Background: In IAMCSST, the time from onset of symptoms to the institution of treatment is directly proportional to the occurrence of clinically relevant events. In this way constant interhospital transfers are a source of delay in the treatment of such pathology, which can lead to unfavorable outcomes such as increased mortality. Objective: To compare mortality among patients diagnosed with ST-segment elevation acute myocardial infarction who had direct or indirect access to the hospital with the capacity to perform Percutaneous Coronary Intervention. Methods: This is a sub-analysis of the VICTIM study with a cross-sectional and quantitative approach. It was developed in the period from December 2014 to June 2018 in the state of Sergipe. A total of 1081 patients were included in the study. Of these, 150 had direct access to hospital with angioplasty and 931 had to be transferred. Results: During the 30 days of IAMCSST, the general mortality rate was 7.4% vs 12.0% (p = 0.040), cardiovascular mortality was 4.3% vs 10.1% (p = 0.017) and mortality was not was 2.7% vs 2.0% (p = 0.904) of the groups with direct and indirect access to the hospital, respectively. Conclusions: From the results we can conclude that the time lost in interhospital transfers implies worse prognoses and consequently increased mortality. This was because the mortality among the groups was higher among patients who had indirect access to the service with the capacity to perform PCI. In this way we can infer that there are more deaths in the population covered by the Unified Health System. Therefore, a more in- depth discussion about the care of these patients is necessary