Background: There is no quality metric for emergency physicians' diagnostic time for acute coronary occlusion. Objective: We sought to quantify diagnostic time associated with automated interpretation, classic STelevation myocardial infarction (STEMI) criteria, STEMIequivalents, and subtle occlusions, using electrocardiogram (ECG)-to-activation of catheterization laboratory time. Methods: This multicenter retrospective study reviewed all code STEMI patients from the emergency department (ED) with confirmed culprit lesions from January 2016 to December 2018. We measured door-to-ECG (DTE) time and ECG-to-activation (ETA) time. We examined the first ED ECGs to determine whether automated interpretation labeled ''STEMI,'' and they met classic STEMI criteria, STEMI-equivalents, or rules for subtle occlusion. ECG analysis was performed by two emergency physicians blinded to clinical scenario, automated interpretation, and angiographic outcome. Results: There were 177 code STEMIs with culprit lesions, with a median DTE time of 9.0 min and a median ETA time of 16.0 min. Automated interpretation labeled 55.4% of first ECGs ''STEMI'' (ETA 6.5 min) and 44.6% not ''STEMI'' (ETA 66 min, p < 0.0001). Of first ECGs, 63.8% met classic STEMI criteria (ETA 8.0 min), 8.5% had STEMI-equivalents (ETA 32.0 min, p = 0.0026), 16.4% had subtle occlusions (ETA 89.0 min, p = 0.045), and 11.3% had no diagnostic sign of occlusion (ETA 68.0 min, p = 0.20). Conclusions: STEMI criteria missed more than one-third of occlusions on first ECG, but most had STEMI-equivalents or rules for subtle occlusion. ETA time can serve as a quality metric for emergency physicians to promote new ECG insights and assess quality improvement initiatives.

No abstract

Objectives: The main objective of this paper is to explore exploratory factor analysis and Spearman's Rank Correlation which indicates the relationship between the duration of the disease with socio-demographic characteristics of the patients presenting to the hospital. Study Design: Prospective Observational Study. Methods: The study was carried out in the Department of Medicine of the Punjab Institute of Medical Science and Hospital (PIMS), Jalandhar for a period of 6 months from June 2018-November 2018 after Recieving approval from the Institutional Ethics Committee. After calculating the sample size using Epi Info, the study was conducted on a total of 250 patients. The study was analyzed using SPSS version 24. Results: The age group of the study was 22 to 86 years. According to the Kolmogorov Smirnov (KS) and Shapiro-Wilk (SW) p value was found to be p=0.009 a and p=0.058 b respectively. Age was found to be normally distributed because the p-value was found above the cutoff point with Skewness-0.200, Kurtosis 0.178 and standard error 0.762. It was observed that there is a significant moderate positive correlation between age and duration of HTN (r = 0.408, p = 0.001). Further analysis was observed that age, social habits and physical activity also has a wide impact on the duration of disease. Conclusion: Numerous factors are observed to be directly associated with the socio-demographic characteristics of the patients. During the study, it was observed that age, social habits and physical activity also has a wide impact on the duration of the disease itself.

No abstract