Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Tipo de documento: | Trabalho de conclusão de curso |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFS |
Texto Completo: | http://ri.ufs.br/jspui/handle/riufs/15736 |
Resumo: | Background: Access to reperfusion therapies in proper time is well-recognized as a factor associated with lower mortality in Acute Myocardial Infarction (AMI). Ideally, patients with acute heart failure, an important gravity factor, should have optimized access to reperfusion therapies. Objective: This study aims to evaluate the access to reperfusion therapies and hospital outcomes, with focus on mortality, in patients with acute heart failure complicating ST Segment Elevation Myocardial Infarction admitted on hospitals with percutaneous coronary intervention (PCI) in the state of Sergipe. Methods: Cross-sectional quantitative study, using data from Victim registry. Data were collected from December 2014 to March 2018. Patients were divided in 2 groups, according to the presence of heart failure signs in hospital admission: (1) No heart failure signs (Killip 1) and (2) heart failure signs (Killip > 1). Results: From the 1071 patients, 918 were on Killip class 1 and 153 on Killip class > 1. When compared to patients with Killip class 1, those on Killip class > 1 had lower access to primary angioplasty (52,9% vs. 37,9%; p = 0,001) and higher percentage of patients who only received drug therapy (19,9% vs. 32,0%; p = 0,001). There were no differences in the use of fibrinolitics (2,1% vs. 3,3%; p = 0,354). Mortality was higher beyond patients with signs of heart failure (6,9% vs. 27,0%; p < 0,001). Conclusion: We observed that patients with heart failure signs present a big delay on the arrival to the hospital with angioplasty centre. They also have lower access to reperfusion therapies, with significative difference in the access to primary angioplasty. A big percentage of these patients receive only drug therapy. The low access to these therapies is one of the factors that contribute to higher mortality in this group of patients. |
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Ramos, Gabriel AndradeBarreto Filho, José Augusto Soares2022-05-20T18:34:10Z2022-05-20T18:34:10Z2019-02-25RAMOS, Gabriel Andrade. Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim. 2019. 50 f. Monografia (Graduação em Medicina) - Centro de Ciências Biológicas e da Saúde, Departamento de Medicina, Universidade Federal de Sergipe, Aracaju, 2019.http://ri.ufs.br/jspui/handle/riufs/15736Background: Access to reperfusion therapies in proper time is well-recognized as a factor associated with lower mortality in Acute Myocardial Infarction (AMI). Ideally, patients with acute heart failure, an important gravity factor, should have optimized access to reperfusion therapies. Objective: This study aims to evaluate the access to reperfusion therapies and hospital outcomes, with focus on mortality, in patients with acute heart failure complicating ST Segment Elevation Myocardial Infarction admitted on hospitals with percutaneous coronary intervention (PCI) in the state of Sergipe. Methods: Cross-sectional quantitative study, using data from Victim registry. Data were collected from December 2014 to March 2018. Patients were divided in 2 groups, according to the presence of heart failure signs in hospital admission: (1) No heart failure signs (Killip 1) and (2) heart failure signs (Killip > 1). Results: From the 1071 patients, 918 were on Killip class 1 and 153 on Killip class > 1. When compared to patients with Killip class 1, those on Killip class > 1 had lower access to primary angioplasty (52,9% vs. 37,9%; p = 0,001) and higher percentage of patients who only received drug therapy (19,9% vs. 32,0%; p = 0,001). There were no differences in the use of fibrinolitics (2,1% vs. 3,3%; p = 0,354). Mortality was higher beyond patients with signs of heart failure (6,9% vs. 27,0%; p < 0,001). Conclusion: We observed that patients with heart failure signs present a big delay on the arrival to the hospital with angioplasty centre. They also have lower access to reperfusion therapies, with significative difference in the access to primary angioplasty. A big percentage of these patients receive only drug therapy. The low access to these therapies is one of the factors that contribute to higher mortality in this group of patients.Fundamento: O acesso a terapias de reperfusão em tempo adequado é imprescindível para diminuir a mortalidade no Infarto Agudo do miocárdio. Idealmente, os pacientes que se apresentam com insuficiência cardíaca, um importante fator de gravidade, deveriam ter acesso otimizado a essas terapias. Todavia, estudos isolados têm mostrado um menor acesso a terapias de reperfusão nesse grupo de pacientes, o que pode contribuir para um maior número de complicações e mortalidade hospitalar Objetivo: Avaliar o acesso a terapias de reperfusão e desfechos hospitalares, com enfoque na mortalidade hospitalar, de pacientes com Infarto Agudo do Miocárdio com Supra de ST (IAMCSST) e sinais de insuficiência cardíaca admitidos em hospitais com capacidade de realizar angioplastia primária no estado de Sergipe. Metodologia: Estudo transversal com abordagem quantitativa que utilizou os dados do registro VICTIM. Os dados foram coletados no período de dezembro de 2014 a março de 2018, em 4 hospitais no estado de Sergipe com serviço de angioplastia. Os pacientes foram subdivididos em 2 grupos, quanto à presença de sinais de insuficiência cardíaca na admissão hospitalar: (1) sem sinais de insuficiência cardíaca (Killip 1) e (2) com sinais de insuficiência cardíaca (Killip > 1) Resultados: Dos 1071 pacientes estudados, 918 se apresentaram com classe Killip 1 e 153 com classe Killip > 1. Quando comparados aos pacientes classe Killip 1, aqueles com classe Killip > 1 tiveram menos acesso à angioplastia primária (52,9% vs. 37,9%; p = 0,001) e maior porcentagem de pacientes que foram submetidos apenas à terapia farmacológica (19,9% vs. 32,0%; p = 0,001). Não houve diferença no acesso a fibrinolíticos (2,1% vs. 3,3%; p = 0,354). A mortalidade hospitalar foi maior entre os pacientes que se apresentaram com sinais de insuficiência cardíaca (6,9% vs. 27,0%; p < 0,001). Conclusão: Observamos que os pacientes admitidos com sinais de insuficiência cardíaca chegam ao hospital capaz de realizar angioplastia primária em um tempo mais prolongado do que o esperado. Esses pacientes têm menor acesso às terapias de reperfusão, com diferenças significativas no acesso à angioplastia primária. O baixo acesso a essas terapias é um dos fatores que contribuem para a maior mortalidade desse grupo de pacientesAracajuporInfarto agudo do miocárdioInsuficiência cardíaca agudaKillipReperfusão miocárdicaMortalidadeAcute Myocardial InfarctionAcute heart failureMyocardial reperfusionMortalityCIENCIAS DA SAUDE::MEDICINAAcesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victiminfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/bachelorThesisUniversidade Federal de SergipeDME - Departamento de Medicina – Aracaju - Presencialreponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/15736/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51ORIGINALGabriel_Andrade_Ramos.pdfGabriel_Andrade_Ramos.pdfapplication/pdf383923https://ri.ufs.br/jspui/bitstream/riufs/15736/2/Gabriel_Andrade_Ramos.pdf2f2cbd6f9dd4830345feace1629d333fMD52TEXTGabriel_Andrade_Ramos.pdf.txtGabriel_Andrade_Ramos.pdf.txtExtracted texttext/plain100178https://ri.ufs.br/jspui/bitstream/riufs/15736/3/Gabriel_Andrade_Ramos.pdf.txt8dce21f95e019c723cb399fbc44dcd22MD53THUMBNAILGabriel_Andrade_Ramos.pdf.jpgGabriel_Andrade_Ramos.pdf.jpgGenerated Thumbnailimage/jpeg1245https://ri.ufs.br/jspui/bitstream/riufs/15736/4/Gabriel_Andrade_Ramos.pdf.jpgb7d408e0fc940f46874e34cdfaa12669MD54riufs/157362022-05-20 15:34:18.407oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2022-05-20T18:34:18Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false |
dc.title.pt_BR.fl_str_mv |
Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim |
title |
Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim |
spellingShingle |
Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim Ramos, Gabriel Andrade Infarto agudo do miocárdio Insuficiência cardíaca aguda Killip Reperfusão miocárdica Mortalidade Acute Myocardial Infarction Acute heart failure Myocardial reperfusion Mortality CIENCIAS DA SAUDE::MEDICINA |
title_short |
Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim |
title_full |
Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim |
title_fullStr |
Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim |
title_full_unstemmed |
Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim |
title_sort |
Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim |
author |
Ramos, Gabriel Andrade |
author_facet |
Ramos, Gabriel Andrade |
author_role |
author |
dc.contributor.author.fl_str_mv |
Ramos, Gabriel Andrade |
dc.contributor.advisor1.fl_str_mv |
Barreto Filho, José Augusto Soares |
contributor_str_mv |
Barreto Filho, José Augusto Soares |
dc.subject.por.fl_str_mv |
Infarto agudo do miocárdio Insuficiência cardíaca aguda Killip Reperfusão miocárdica Mortalidade |
topic |
Infarto agudo do miocárdio Insuficiência cardíaca aguda Killip Reperfusão miocárdica Mortalidade Acute Myocardial Infarction Acute heart failure Myocardial reperfusion Mortality CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Acute Myocardial Infarction Acute heart failure Myocardial reperfusion Mortality |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Background: Access to reperfusion therapies in proper time is well-recognized as a factor associated with lower mortality in Acute Myocardial Infarction (AMI). Ideally, patients with acute heart failure, an important gravity factor, should have optimized access to reperfusion therapies. Objective: This study aims to evaluate the access to reperfusion therapies and hospital outcomes, with focus on mortality, in patients with acute heart failure complicating ST Segment Elevation Myocardial Infarction admitted on hospitals with percutaneous coronary intervention (PCI) in the state of Sergipe. Methods: Cross-sectional quantitative study, using data from Victim registry. Data were collected from December 2014 to March 2018. Patients were divided in 2 groups, according to the presence of heart failure signs in hospital admission: (1) No heart failure signs (Killip 1) and (2) heart failure signs (Killip > 1). Results: From the 1071 patients, 918 were on Killip class 1 and 153 on Killip class > 1. When compared to patients with Killip class 1, those on Killip class > 1 had lower access to primary angioplasty (52,9% vs. 37,9%; p = 0,001) and higher percentage of patients who only received drug therapy (19,9% vs. 32,0%; p = 0,001). There were no differences in the use of fibrinolitics (2,1% vs. 3,3%; p = 0,354). Mortality was higher beyond patients with signs of heart failure (6,9% vs. 27,0%; p < 0,001). Conclusion: We observed that patients with heart failure signs present a big delay on the arrival to the hospital with angioplasty centre. They also have lower access to reperfusion therapies, with significative difference in the access to primary angioplasty. A big percentage of these patients receive only drug therapy. The low access to these therapies is one of the factors that contribute to higher mortality in this group of patients. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019-02-25 |
dc.date.accessioned.fl_str_mv |
2022-05-20T18:34:10Z |
dc.date.available.fl_str_mv |
2022-05-20T18:34:10Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/bachelorThesis |
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bachelorThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
RAMOS, Gabriel Andrade. Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim. 2019. 50 f. Monografia (Graduação em Medicina) - Centro de Ciências Biológicas e da Saúde, Departamento de Medicina, Universidade Federal de Sergipe, Aracaju, 2019. |
dc.identifier.uri.fl_str_mv |
http://ri.ufs.br/jspui/handle/riufs/15736 |
identifier_str_mv |
RAMOS, Gabriel Andrade. Acesso a terapias de reperfusão e mortalidade hospitalar de pacientes com IAMCSST admitidos com insuficiência cardíaca – registro victim. 2019. 50 f. Monografia (Graduação em Medicina) - Centro de Ciências Biológicas e da Saúde, Departamento de Medicina, Universidade Federal de Sergipe, Aracaju, 2019. |
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por |
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Universidade Federal de Sergipe |
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DME - Departamento de Medicina – Aracaju - Presencial |
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