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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2021.tde-07022022-181723
Document
Author
Full name
Túlio Torres Vargas
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2021
Supervisor
Committee
Pazin Filho, Antonio (President)
Souza, Heraldo Possolo de
Brasileiro Filho, Geraldo
Title in Portuguese
Impacto da pandemia de COVID-19 sobre indicadores de atendimento ao Infarto do Miocárdio com Supradesnivelamento de ST em pacientes admitidos na Santa Casa de Passos (MG)
Keywords in Portuguese
COVID-19
Indicadores de qualidade em assistência à saúde
Infarto do Miocárdio com Supradesnível do Segmento ST
Reperfusão
Abstract in Portuguese
INTRODUÇÃO: Publicações demonstram que a pandemia de COVID-19 impactou negativamente os indicadores de atendimento ao Infarto Agudo do Miocárdio com Supradesnivelamento de ST (IAMCSST) com aumento de sua morbimortalidade. OBJETIVOS: Comparar a mortalidade, o tempo entre início dos sintomas até a angioplastia primária (Retardo Total - RT), o tempo entre início dos sintomas até o atendimento médico inicial (Retardo do Paciente - RP) e o tempo entre atendimento médico inicial e a introdução do fio-guia no laboratório de Hemodinâmica (Retardo do Sistema - RS) entre os pacientes admitidos por IAMCSST no Serviço de Hemodinâmica da Santa Casa de Passos-MG (SCMP) - antes e depois de decretada a pandemia pela OMS, avaliando o impacto da pandemia de COVID-19 nos indicadores de atendimento de IAMCSST. MÉTODOS: Estudo de tipo antes e depois, envolvendo pacientes internados na SCMP com IAMCSST e submetidos a angioplastia primária, com dados coletados retrospectivamente por meio da revisão de prontuários e prospectivamente a partir da aprovação no Comitê de Ética em Pesquisa. RESULTADOS: Não houve diferenças no RT [Pré-pandemia: 300´ (±159´), IC 95% (277,1; 322,6); Pandemia: 300´ (±148´), IC 95% (274,3; 326,6), com p=0,97]. Houve aumento do RS [Pré-pandemia: 145±97, IC 95% (122,7; 167,9); Pandemia: 178±96, IC 95% (157,4; 197,9), com p=0,037]. Não houve aumento do RP e tampouco diferenças em mortalidade. CONCLUSÕES: A pandemia de COVID-19 aumentou o RS em nossa região, indicador que se correlaciona com aumento de mortalidade em longo prazo por IAMCSST.
Title in English
Impact of the COVID-19 pandemic on care indicators for ST-segment elevation Myocardial Infarction in patients admitted at Santa Casa de Passos (MG)
Keywords in English
COVID-19
Health care
Quality indicators
Reperfusion
ST Elevation Myocardial Infarction
Abstract in English
INTRODUCTION: International data reveals that the COVID-19 pandemic negatively impacted the care indicators for Acute Myocardial Infarction with ST Elevation Myocardial Infarction (STEMI) with an increase in its morbidity and mortality. GOALS: Compare mortality rates, time between symptom onset until primary angioplasty (Total Delay), time between symptom onset and initial medical care (Patient Delay) and time between initial medical care to the guidewire insertion at the Cath Lab (System Delay) among patients admitted by STEMI in the Interventional Cardiology Service of Santa Casa de Passos-MG (SCMP) - before and after the pandemic was decreed by WHO, evaluating the impact of the COVID-19 pandemic on the STEMI care indicators. METHODS: Before and after study, involving patients hospitalized at SCMP with STEMI and undergoing primary angioplasty, with data collected retrospectively through the review of medical records and prospectively after approval by the Research Ethics Committee. RESULTS: There were no differences in Total Delay [Pre-pandemic: 300' (±159'), 95% CI (277.1; 322.6); Pandemic: 300' (±148'), 95% CI (274.3; 326.6), with p=0.97]. There was an increase in the System Delay [Pre-pandemic: 145±97, 95% CI (122.7; 167.9); Pandemic: 178±96, 95% CI (157.4; 197.9), with p=0.037]. There was no increase in Patient Delay non differences in mortality. CONCLUSION: The COVID-19 pandemic increased the System Delay in our region, an indicator that correlates with an increase in long-term mortality from STEMI.
 
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TULIOTORRESVARGAS.pdf (1.52 Mbytes)
Publishing Date
2022-02-21
 
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