RELATIONSHIP BETWEEN DOOR-TO-BALLOON TIME AND CLINICAL EXPERIENCE LEVEL
OF EMERGENCY DEPARTMENT PHYSICIANS
Abstract
Background: This study aimed to investigate the relationship between the
experience level of physicians who initially make a clinical diagnosis
of patients with ST segment elevation myocardial infarction in the
emergency department and door-to-balloon time (DBT). Material and
methods: Between January and December 2018, the research group was
selected randomly among 522 patients with ST elevation myocardial
infarction who were immediately treated in the catheter laboratory.
Angiography images were monitored from the patients’ records in the
catheter laboratory. The time of admission to the emergency room was
obtained using the hospital registration system. The experience level of
physicians who initially clinically diagnosed patients in the emergency
department was divided into three groups: medical practitioner (who did
not receive emergency training), assistant physician (undergoing
emergency medicine training), and emergency medicine specialist.
Results: The study included 522 patients who underwent primary
percutaneous intervention due to ST segment elevation myocardial
infarction. The mean age was lower, and cardiogenic shock and mortality
rates were lower in the group with DBT<60 /min compared with
the group with DBT>60/min. In the expert group, the mean
DBT was lower, but the cardiogenic shock and mortality rates were higher
(p<0.05). Conclusions: The duration of DBT decreases as the
experience level of the emergency physician increases, but randomization
is required to determine its clinical benefit