ST Elevation Myocardial Infarction
Conditions
Keywords
clinical performance, quality measures, ST-Elevation myocardial infarction
Brief summary
This study aims to investigate and evaluate clinical performance and quality measures for adults with acute ST-elevation myocardial infarction (STEMI) in China. Further more, the investigates like to develop quality improvement strategies and relevant tools focusing on treatment and clinical outcome in patients with STEMI. This is a annually survey , through consecutively recruiting all eligible inpatients and collecting relevant medical information, the performance of all participating hospitals. Further, quality improvement strategies including summary of clinical performance and quality measures, clinical pathways and team building will be organized for the purpose of quality improvement. All hospitals will consecutively recruit qualified patients in the same method adopted in baseline period. Then the reperfusion rates and other performance measures will be compared annually.
Detailed description
Cardiovascular disease (CVD) is a major concern in public health globally, as well as in China, and remarkable variations of resources available and health system performance have been noted. Acute myocardial infarction is one of the leading causes of mortality and morbidity, both in rural and urban area. This study aims to investigate and evaluate clinical performance and quality measures for adults with acute ST-elevation myocardial infarction (STEMI) in China. Further more, the investigates like to develop quality improvement strategies and relevant tools focusing on treatment and clinical outcome in patients with STEMI. This is a annually survey , through consecutively recruiting all eligible inpatients and collecting relevant medical information, the performance of all participating hospitals. Demographic characteristics, clinical features, diagnostic tests, medications, procedures, and in-hospital outcomes of patients will be obtained and then, the treatment pattern and outcomes will be evaluated. Further, quality improvement strategies including summary of clinical performance and quality measures, clinical pathways and professional training will be organized for the purpose of quality improvement. All hospitals will consecutively recruit qualified patients in the same method adopted in baseline period. Then the reperfusion rates and other performance measures will be compared annually. New knowledge will be generated about STEMI management in China, to improve STEMI patients prognosis in future.
Interventions
BEHAVIORALQuality improvement strategies and tools
Quality improvement strategies and tools
Sponsors
China National Center for Cardiovascular Diseases
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with STEMI who arrive at the hospital within 48 hours from the symptoms onset.
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 30-day cardiac mortality | From admission to 30days | Proportion of patients who were cardiac death from admission to 30days |
| Aspirin at arrival | 24 hours after admission | Proportion of aspirin use within 24 hours of admission among eligible patients |
| Clopidogrel (or ticagrelor) at arrival | 24 hours after admission | Proportion of Clopidogrel (or ticagrelor) use within 24 hours of admission among eligible patients |
| β-blockers at arrival | 24 hours after admission | Proportion of β-blockers use within 24 hours of admission among eligible patients |
| 30-day readmission rates | From hospital discharge to 30 days | Proportion of patients readmission from hospital discharge to 30days |
| ECG at arrival | 24 hours after admission | Proportion of ECG test within 10 minutes of admission among eligible patients |
| Reperfusion therapy rate | 24 hours after admission | Reperfusion therapy rate is defined as utilization rate of thrombolytic therapy or primary PCI treatment among patients indicated with the reperfusion therapy. |
| Time delay from failure of fibrinolysis to angiography(The time from start of fibrinolysis to evaluation of its efficacy is 60-90min) | 10 days on average (during hospitalization) | The proportion of failure of fibrinolysis to balloon within 90 minutes among all patients receiving PCI. |
| Cost during hospitalization | 10 days on average (during hospitalization) | Cost during hospitalization |
| Time delay from start of fibrinolysis to angiography(if fibrinolysis is successful) | 10 days on average (during hospitalization) | The proportion of from fibrinolysis to balloon (if fibrinolysis is successful) within 2-24hours among all patients receiving PCI. |
| Timeliness of thrombolytic therapy | 24 hours after admission | The proportion of door to needle time (D2N) within 30 minutes among all patients receiving fibrinolytic therapy. |
| Timeliness of primary PCI | 24 hours after admission | The proportion of door to balloon (D2B) within 90 minutes among all patients receiving primary PCI. |
| Door-in-Door-Out Time | 24 hours after admission | Percentage of patients whose median time from the emergency department arrival at STEMI referral facility to emergency department discharge from STEMI referral facility is equal or less than 30 min. discharge from STEMI referral facility is 30 min. |
| Time to Primary PCI Among Transferred Patients | 24 hours after admission | Percentage of patients whose median time from first medical contact (at or before emergency department arrival to the STEMI referral facility \[e.g., non-PCI-capable facility\]) to primary PCI at the STEMI receiving facility (PCI-capable facility) is equal or less than 120 min |
| Evaluation of LDL-C | 10 days on average (during hospitalization) | Percentage of patients with documentation in the hospital record that LDL-C is evaluated during hospitalization |
| Evaluation of left ventricular ejection fraction | 10 days on average (during hospitalization) | Percentage of patients with documentation in the hospital record that left ventricular ejection fraction is evaluated during hospitalization |
| 30-day all-cause mortality | From admission to 30days | Proportion of patients who were all-cause death from admission to 30days |
| Aspirin use during hospitalization | 10 days on average (during hospitalization) | Proportion of Aspirin use during hospitalization among eligible patients. |
| Clopidogrel (or ticagrelor) use during hospitalization | 10 days on average (during hospitalization) | Proportion of Clopidogrel (or ticagrelor) use during hospitalization among eligible patients. |
| β-blockers use during hospitalization | 10 days on average (during hospitalization) | Proportion of β-blockers use during hospitalization among eligible patients. |
| Angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use during hospitalization | 10 days on average (during hospitalization) | Proportion of Angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use during hospitalization among eligible patients. |
| Statins use during hospitalization | 10 days on average (during hospitalization) | Proportion of statins use during hospitalization among eligible patients. |
| Aspirin use at discharge | 10 days on average (during hospitalization) | Proportion of aspirin use at discharge among eligible patients. |
| Clopidogrel (or ticagrelor) use at discharge | 10 days on average (during hospitalization) | Proportion of Clopidogrel (or ticagrelor) use at discharge among eligible patients. |
| β-blockers use at discharge | 10 days on average (during hospitalization) | Proportion of β-blockers use at discharge among eligible patients. |
| angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use at discharge | 10 days on average (during hospitalization) | Proportion of angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use at discharge among eligible patients. |
| Statins use at discharge | 10 days on average (during hospitalization) | Proportion of statins use at discharge among eligible patients. |
| Aldosterone Antagonist at Discharge | 10 days on average (during hospitalization) | Proportion of Aldosterone Antagonist use at discharge among eligible patients. |
| Smoking cessation advice/ counseling at Discharge | 10 days on average (during hospitalization) | Proportion of patients received smoking cessation advice/ counseling |
| all-cause mortality during hospitalization | 10 days on average (during hospitalization) | Proportion of patients who were all-cause death during hospitalization |
| Cardiac mortality during hospitalization | 10 days on average (during hospitalization) | Proportion of patients who were cardiac death during hospitalization |
Countries
China
Contacts
Primary ContactHongjian Wang
Backup ContactKefei Dou
Outcome results
None listed