A NATIONAL audit of how hospitals perform when dealing with a coronary emergency has put Limerick in the top two in Ireland for meeting targets set by the national clinical programme.
Key findings for University Hospital Limerick (UHL) included that 94 per cent of all STEMI patients – patients suffering a heart attack with a completely blocked artery – received timely treatment to restore blood flow, just one of two hospitals which exceeded the target of 90 per cent. Timely treatment, getting blood flow restored within 120 minutes, is associated with reduced patient mortality.
75 per cent of STEMI heart attack patients transferred from another hospital got timely primary care compared to 41 per cent nationally.
79 per cent of STEMI patients arriving by ambulance bypassed the ED and went directly to the cath lab, compared to the national average of 73 per cent and against a national target of 80 per cent.
Commenting on the audit findings, Prof Tom Kieran, Consultant Interventional Cardiologist at UHL and HSE National Lead for Primary PCI (Percutaneous Coronary Intervention – treating heat blockages without surgery), said: “This is a very timely review for our service and for our region. One of the things to remember is that we are probably the youngest primary PCI centre in the country, having been set up in 2013.”
“Over the last 10 years of work, the interventional cardiologists and their teams, including NCHDs, cardiac physiologists, nurses, and radiographers, have led an improved service and seen very positive outcomes for patients where inpatient mortality for STEMI is on a par with, if not better than, the rest of the country. We have been given 10 years to prove we are up to the job and it is important to acknowledge the success stories in our region.”
“The national picture shows that 82 per cent of patients who arrive at a primary PCI centre receive timely reperfusion, but that only 41 per cent of patients who arrive at a non-primary PCI centre receive timely reperfusion. So hospital transfers is an area for improvement that colleagues around the country are focusing on.
“In our hospital, we get transfers from within our own hospital group and also from University Hospital Kerry. Our figures are quite good in terms of transfers but we need to strive for better here and around the country.”
Recommendations in the audit also focus on greater public awareness and Prof Kiernan said a new national campaign needs to encourage more patients to make a call on chest pain early.
“As it stands at the moment, only 44 per cent of patients call an ambulance within an hour of symptoms. If patients are at home and if they have chest pain, they need to call us early. Time is muscle. If you get to us early, you will have a better outcome. The international evidence on that is very clear and it is something we cannot emphasise enough,” said Prof Kiernan.