O impacto da localização geográfica de início dos sintomas no uso das terapias de reperfusão e na mortalidade do infarto do miocárdio em Sergipe

• Autor(a) principal: Conceição, Flávio Mateus do Sacramento
• Data de Publicação: 2018
• 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/7582
• topic: Medicina; Saúde; Infarto do miocárdio em Sergipe (SE); Reperfusão miocárdica em Sergipe (SE); Mortalidade em Sergipe (SE); Medicine; Myocardial infarction in Sergipe (SE); Myocardial reperfusion in Sergipe (SE); Mortality in Sergipe (SE); CIENCIAS DA SAUDE::MEDICINA

Background: The concentration of services and specialized professionals in the capital and metropolitan regions can justify the difficulty of access to reperfusion therapies in patients with STEMI who initiate symptoms outside the metropolitan region. Objective: To compare the rate of use of reperfusion therapies among patients with STEMI who initiated the symptoms in the metropolitan and metropolitan region of Sergipe, as well as to evaluate the 30-day mortality rate between groups. Methods: This is a subanalysis of the VICTIM study, in which 878 patients with STEMI were evaluated between 2014 and 2017, in the only four hospitals capable of performing angioplasty in Sergipe. The patients were divided into two groups, regarding the place of onset of symptoms: 1. metropolitan region and 2. metropolitan region of Sergipe. A significant difference was considered with p <0.05. Results: Of the 878 patients, 496 had onset of symptoms in the non-metropolitan region of the state and in 382, the onset of symptoms occurred in the metropolitan region. Primary angioplasty was used in 45.2% vs 58.9% (p <0.001), thrombolytic (3.0% vs 1.3%, p = 0.091), some type of reperfusion (48.2% vs 60, 2%, p <0.001), and the 30-day mortality rate was 14% vs. 7.7% (p <0.004), respectively, among patients who had onset of symptoms in the metropolitan and metropolitan areas of the state. Conclusion: The present study confirmed a significant disparity in access to reperfusion therapy and general mortality among patients who started the symptoms in the metropolitan region of Sergipe and beyond. In addition, there is a general sub-assumption of reperfusion therapies in the state.