Door-to-balloon Time in Cardiovascular Emergency Care in a Hospital of Northern Brazil

Abstract Background The use of an adequate door-to-balloon time (≤ 90 minutes) is crucial in improving the quality of care provided to patients with ST-segment elevation myocardial infarction (STEMI). Objective To determine the door-to-balloon time in the management of STEMI patients in a cardiovascular emergency department in a hospital of northern Brazil. Methods This was a cross-sectional study based on review of medical records. A total of 109 patients with STEMI admitted to the emergency department of a referral cardiology hospital in Pará State, Brazil, between May 2017 and December 2017. Correlations of the door-to-balloon time with length of hospital stay and mortality rate were assessed, as well as whether the time components of the door-to-balloon time affected the delay in performing primary percutaneous coronary intervention. Quantitative variables were analyzed by Spearman correlation and the G test was used for categorical variables. A p<0.05 was set as statistically significant. Results Median door-to-balloon time was 104 minutes. No significant correlation was found between door-to-balloon time and length of hospital stay or deaths, but significant correlations were found between door-to-balloon time and door-to-ECG time (p<0.001) and ECG-to-activation (of an interventional cardiologist) time (p<0.001). Conclusion The door-to-balloon time was longer the recommended and was not correlated with the length of hospital stay or in-hospital mortality. Door-to-ECG time and ECG-to-activation time contributed to the delay in performing the primary percutaneous coronary intervention. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

Integrative review on the incidence of HIV infection and its socio-spatial determinants / Revisión integrativa sobre incidencia de infección por VIH y sus determinantes socioespaciales / Revisão integrativa sobre incidência de infecção pelo HIV e seus determinantes socioespaciais

ABSTRACT Objectives: to identify the socio-spatial determinants associated with the incidence of infection by the human immunodeficiency virus (HIV) described in national and international literature. Methods: integrative literature review that included original articles indexed in the LILACS, PUBMED, CINAHL, and Scopus databases, from 2015 to 2019. The synthesis of the articles was done in a descriptive manner in two categories according to the type of approach. Results: 13 articles were selected, with a predominance of ecological studies. Regions with deficient access to health services, high population density, higher rates of poverty, intense migratory flow, border areas, as well as precarious socioeconomic conditions, and risk behaviors are associated with higher rates of infection. Final Considerations: the influence of regional inequalities on the incidence of HIV infection is revealed, confirming the relevance of spatial analysis techniques for mapping the distribution of diseases and identifying risk areas.

RESUMEN Objetivos: identificar los determinantes socioespaciales relacionados a la incidencia de infección por virus de la inmunodeficiencia humana (VIH) descritos en la literatura nacional e internacional. Métodos: revisión integrativa de la literatura que incluyó artículos originales indexados en las bases de datos LILACS, PUBMED, CINAHL y Scopus, de 2015 a 2019. Síntesis de artículos hecha de manera descriptiva en dos categorías segundo el tipo de abordaje. Resultados: seleccionados 13 artículos, con predominio de estudios ecológicos. Regiones con acceso deficiente a los servicios de salud, alta densidad poblacional, mayores índices de pobreza, intenso flujo migratorio, áreas fronterizas, bien como precarias condiciones socioeconómicas y comportamientos de riesgo están relacionados a las mayores tasas de infección. Consideraciones Finales: se revela influencia de las desigualdades regionales sobre la incidencia de infección por VIH, ratificando la relevancia de técnicas de análisis espacial para el mapeo de la distribución de enfermedades e identificación de áreas de riesgo.

RESUMO Objetivos: identificar os determinantes socioespaciais associados à incidência de infecção pelo vírus da imunodeficiência humana (HIV) descritos na literatura nacional e internacional. Métodos: revisão integrativa da literatura que incluiu artigos originais indexados nas bases de dados LILACS, PUBMED, CINAHL e Scopus, no recorte temporal de 2015 a 2019. A síntese dos artigos foi feita de forma descritiva em duas categorias segundo o tipo de abordagem. Resultados: foram selecionados 13 artigos, com predomínio de estudos ecológicos. Regiões com acesso deficiente aos serviços de saúde, alta densidade populacional, maiores índices de pobreza, intenso fluxo migratório, áreas fronteiriças, bem como precárias condições socioeconômicas e comportamentos de risco estão associados às maiores taxas de infecção. Considerações Finais: revela-se a influência das desigualdades regionais sobre a incidência de infecção pelo HIV, ratificando a relevância das técnicas de análise espacial para o mapeamento da distribuição de doenças e identificação de áreas de risco.