Distância e tempo percorridos pelos pacientes do SUS com IAMCSST até o hospital com angioplastia primária

Abstract

Background: The delay access to reperfusion therapy in patients with STEMI can compromise the benefits of such measures, as well as generating significant complications. Thus, the time and distance traveled between the onset of symptoms until access to reperfusion therapies directly influence the prognosis and therefore the mortality of affected by this pathology. Objectives: Describe the temporal and geographical course of STEMI patients served by SUS in Sergipe, from the onset of symptoms to arrival at the only public hospital able to perform primary angioplasty in Sergipe. Methods: We used the VICTIM record (Via Crucis for Myocardial Infarction Treatment) conducted from data from the only public hospital data with ability to perform primary angioplasty in the state of Sergipe. The study included 403 patients from May 2013 to April 2015, admitted with a diagnosis of STEMI. Clinical and demographic factors were analyzed, besides the description of the temporal and geographic course taken by the patient from the onset of symptoms until the completion of primary angioplasty, with the distance estimated by Google Maps. Results: The real-time spent by patients had values widened as compared to the estimated time, considered ideal, over the same path. From the local call for help until the first hospital service, the estimated time vs real seen were 0.24h ± 0.28h vs 1.2h ± 3.9h (p <0.001) for an estimated distance of 12Km ± 19,7Km, while from this first medical care to the hospital with primary angioplasty was expected that the time were 0.9h ± 0.77h, but the time observed was 22h ± 30.1h (p < 0.001), for a distance of 57km ± 54km. The total time, estimated vs real, corresponded to 0.98h ± 0.82h vs 28.4h 37.5h (p <0.001) for a total estimated distance 57.6Km ± 59.6Km. Conclusion: The distance traveled and time spent by public patients are high. This shows that the logistics of care of patients with STEMI in Sergipe and access to hospital with definitive treatment needs immediate improvement.