Abstract

SPROCKEL, John J. et al. Quality of care in acute coronary syndromes: a critical path implementation. Rev. Colomb. Cardiol. [online]. 2015, vol.22, n.3, pp.119-126. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2014.10.010.

Background: In recent years there have been important advances in acute coronary syndrome (ACS) management, which translates into a drop in mortality in this group of patients. Objective: To describe the results of the implementation of a critical path for the management of ACS, at the emergency service of the Hospital San José in Bogotá, between March 1^st, 2012 and February 28^th, 2013. Methods: A prospective descriptive observational study was carried out. The critical pathway was structured upon consensus among the services of internal medicine, emergency, and cardiology. This pathway was structured to be applied within the first 24 hours of the patient's treatment with the final ACS. Results: 156 patients were selected, 25 had ST segment elevation ACS and 131 had ACS non- ST segment elevation. 96% of ST segment elevation ACS underwent some reperfusion strategy, 2 (9.5%) patients died. As far as non- ST segment elevation ACS patients are concerned, 33 (25.1%) patients exhibited infarction and 98 (74.9%) unstable angina, with a mortality of 4 (3.2%) patients. The use of aspirin, betablockers, statin, and ACEI or ARA II during the first 24 hours was above 90% in the totality of the sample. Conclusions: It is demonstrated that a higher level of fulfillment is achieved for the performance measures for ACS care upon a critical pathway implementation.

Keywords : Chest pain; Acute coronary syndrome; Critical pathway; Optimal medical treatment; ECG.

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