Impact of the Participation in the Fast Tract STEMI Project on the Mortality of Patients with Acute Myocardial Infarction, Nangrong Hospital, Buriram - ผลของการเข้าร่วมโครงการ Fast Track STEMI ต่อการเสียชีวิตของผู้ป่วยโรคกล้ามเนื้อหัวใจขาดเลือดเฉียบพลัน โรงพยาบาลนางรอง จังหวัดบุรีรัมย์

Abstract

Acute myocardial infarction is serious, acute illness causing sudden deaths of the patients. Rapid
access to services and urgent medication with streptokinase could increase the chance of survival. To
address the high incidence of the disease, Nangrong Hospital of Burirum province had participated in
the fast tract STEMI project of Maharat Nakornrachasima Hospital in order to expedite medical care
process. The objective of this study was to assess the impact of participation on treatment procedures,
the outcomes and the case fatality. The study was conducted as a quasi-experimental research during
May 2010 – April 2011. The study samples were 73 patients with acute myocardial infarction who fit
with the eligible criteria. Assessment was performed quarterly based on the data collected from hospital
records, STEMI management forms, meeting records and data on related treatment events. It was found
that 68.75% of patients who needed drugs were able to get drug (door to needle time) within 30
minutes (compared to zero percent before the participation); and the fastest record was within 10
minutes. Case fatality was 2.74 which occurred during transportation. Therefore, the model which was
comprised of clear and precise written management system, on-duty preparedness, teamwork, and
holistic care provision, could be a prototype for improving care to patients with acute myocardial
infarction; and should be widely promoted.
Key words: acute myocardial infarction, experimental research and development, fast track STEMI