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.
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.
Study Type
OBSERVATIONAL
Enrollment
200,000
Quality improvement strategies and tools
Hongjian Wang
Beijing, Beijing Municipality, China
RECRUITINGAspirin at arrival
Proportion of aspirin use within 24 hours of admission among eligible patients
Time frame: 24 hours after admission
Clopidogrel (or ticagrelor) at arrival
Proportion of Clopidogrel (or ticagrelor) use within 24 hours of admission among eligible patients
Time frame: 24 hours after admission
β-blockers at arrival
Proportion of β-blockers use within 24 hours of admission among eligible patients
Time frame: 24 hours after admission
ECG at arrival
Proportion of ECG test within 10 minutes of admission among eligible patients
Time frame: 24 hours after admission
Reperfusion therapy rate
Reperfusion therapy rate is defined as utilization rate of thrombolytic therapy or primary PCI treatment among patients indicated with the reperfusion therapy.
Time frame: 24 hours after admission
Time delay from failure of fibrinolysis to angiography(The time from start of fibrinolysis to evaluation of its efficacy is 60-90min)
The proportion of failure of fibrinolysis to balloon within 90 minutes among all patients receiving PCI.
Time frame: 10 days on average (during hospitalization)
Time delay from start of fibrinolysis to angiography(if fibrinolysis is successful)
The proportion of from fibrinolysis to balloon (if fibrinolysis is successful) within 2-24hours among all patients receiving PCI.
Time frame: 10 days on average (during hospitalization)
Timeliness of thrombolytic therapy
The proportion of door to needle time (D2N) within 30 minutes among all patients receiving fibrinolytic therapy.
Time frame: 24 hours after admission
Timeliness of primary PCI
The proportion of door to balloon (D2B) within 90 minutes among all patients receiving primary PCI.
Time frame: 24 hours after admission
Door-in-Door-Out Time
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 frame: 24 hours after admission
Time to Primary PCI Among Transferred Patients
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
Time frame: 24 hours after admission
Evaluation of LDL-C
Percentage of patients with documentation in the hospital record that LDL-C is evaluated during hospitalization
Time frame: 10 days on average (during hospitalization)
Evaluation of left ventricular ejection fraction
Percentage of patients with documentation in the hospital record that left ventricular ejection fraction is evaluated during hospitalization
Time frame: 10 days on average (during hospitalization)
Aspirin use during hospitalization
Proportion of Aspirin use during hospitalization among eligible patients.
Time frame: 10 days on average (during hospitalization)
Clopidogrel (or ticagrelor) use during hospitalization
Proportion of Clopidogrel (or ticagrelor) use during hospitalization among eligible patients.
Time frame: 10 days on average (during hospitalization)
β-blockers use during hospitalization
Proportion of β-blockers use during hospitalization among eligible patients.
Time frame: 10 days on average (during hospitalization)
Angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use during hospitalization
Proportion of Angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use during hospitalization among eligible patients.
Time frame: 10 days on average (during hospitalization)
Statins use during hospitalization
Proportion of statins use during hospitalization among eligible patients.
Time frame: 10 days on average (during hospitalization)
Aspirin use at discharge
Proportion of aspirin use at discharge among eligible patients.
Time frame: 10 days on average (during hospitalization)
Clopidogrel (or ticagrelor) use at discharge
Proportion of Clopidogrel (or ticagrelor) use at discharge among eligible patients.
Time frame: 10 days on average (during hospitalization)
β-blockers use at discharge
Proportion of β-blockers use at discharge among eligible patients.
Time frame: 10 days on average (during hospitalization)
angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use at discharge
Proportion of angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use at discharge among eligible patients.
Time frame: 10 days on average (during hospitalization)
Statins use at discharge
Proportion of statins use at discharge among eligible patients.
Time frame: 10 days on average (during hospitalization)
Aldosterone Antagonist at Discharge
Proportion of Aldosterone Antagonist use at discharge among eligible patients.
Time frame: 10 days on average (during hospitalization)
Smoking cessation advice/ counseling at Discharge
Proportion of patients received smoking cessation advice/ counseling
Time frame: 10 days on average (during hospitalization)
all-cause mortality during hospitalization
Proportion of patients who were all-cause death during hospitalization
Time frame: 10 days on average (during hospitalization)
Cardiac mortality during hospitalization
Proportion of patients who were cardiac death during hospitalization
Time frame: 10 days on average (during hospitalization)
30-day all-cause mortality
Proportion of patients who were all-cause death from admission to 30days
Time frame: From admission to 30days
30-day cardiac mortality
Proportion of patients who were cardiac death from admission to 30days
Time frame: From admission to 30days
30-day readmission rates
Proportion of patients readmission from hospital discharge to 30days
Time frame: From hospital discharge to 30 days
Cost during hospitalization
Cost during hospitalization
Time frame: 10 days on average (during hospitalization)
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