| Abstract | Emergency medicine, a field relatively new to even the most developed societies, is in its infancy in Kosova. The general aim of the study was to evaluate the impact of pre-hospital and hospital emergency care in the prognosis of patients admitted to the hospital with ACS. This observational prospective clinical study has included all cases of ACS patients admitted to emergency department of UCCK between January 1, 2011 and December 31, 2012. During this period 1498 patients diagnosed as ACS, from which 36.4% were females. By age, 69.4% were younger than 70 years. In a higher percentage, females were 70 and older compared to males (37.2% vs 26.9%; p=0,000). 22.6% were diagnosed as UA, 33.3% as STEMI and 44.1% as NSTEMI. In PHE group were 170 or 11.3% of patients. Women often used PHE services compared to males (13.4% vs.10.2%; p=0,063). In hospital mortality rate for ACS was 10.3% with significant difference by gender (F 12.5% vs. M 9.0%; p=0,941). Patients with ACS in 56.5% of cases had hypertension, 30.6% diabetes, 10.2% Obese; 36.2% Current smokers. The mortality rate was higher in PHE patients 28.8% vs. control group 7.9%, with significant statistical difference (p=0,000). This high mortality rate of patients who have been using PHE
services can be explained by the fact that they were more often STEMI patients, older than patients of control group, 40.0% who were 70 years or older. |
| Abstract (english) | Hitna medicina, djelatnost medicine koja je relativno nova čak i u najrazvijenijim društvima, u povojima je na Kosovu. Opći cilj ove studije bio je procijeniti utjecaj pred-bolničke i bolničke hitne skrbi na ishod bolesti u bolesnika koji su primljeni u bolnicu radi ACS. Ova opservacijska, prospektivna, klinička studija uključila je sve slučajeve bolesnika s ACS-om koji su primljeni u hitnu službu UCCK-a između 1. siječnja 2011. i 31. prosinca 2012. godine. U tom razdoblju bolnički je liječeno 1498 bolesnika s dijagnozom ACS, od čega su žene činile 36,4%, a 69,4 % bolesnika bilo je mlađe od 70 godina. Žene su bile 70 i više godina starosti u odnosu na muškarce (37,2% prema 26,9%; p=0,000). Klinička prezentacija nestabilnom
anginom bila je u 22,6%, 33,3% STEMI i 44,1% NSTEMI bolesnika. U skupini PHE bilo je 170 ili 11,3% bolesnika. Žene su češće koristile PHE usluge u odnosu na muškarce (13,4% naprama 10,2%; p=0,063). Ukupna bolnička smrtnost za ACS bila je 10,3% sa statistički značajnom razlikom prema spolu (žene 12,5%, muškarci 9,0%; p=0,941). Bolesnici s ACS-om u 56,5% slučajeva bolovali su od arterijske hipertenzije, u 30,6% od šećerne bolesti, 10,2% bili su pretili i 36,2% bili su aktivni pušači. Stopa smrtnosti bila je veća u bolesnika s PHE 28,8% u odnosu na kontrolnu skupinu 7,9%; p=0,000. Ova visoka stopa smrtnosti bolesnika koji su koristili PHE uslugu može se objasniti činjenicom da su ti bolesnici češće imali STEMI i da su bili stariji od 70 godina. |
